Recurrent Bilateral Focal Myositis

This report describes a rare case of recurrent bilateral focal myositis and its successful treatment via methotrexate. A 38-year-old man presented myalgia of the right gastrocnemius in May 2005. Magnetic resonance imaging showed very high signal intensity in the right gastrocnemius on short-tau inve...

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Published inInternal Medicine Vol. 55; no. 22; pp. 3369 - 3374
Main Authors Nagafuchi, Hiroko, Nakano, Hiromasa, Ooka, Seido, Takakuwa, Yukiko, Yamada, Hidehiro, Tadokoro, Mamoru, Shimojo, Sadatomo, Ozaki, Shoichi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2016
Subjects
Adult
Anti-Inflammatory Agents - therapeutic use
bilateral
Case Report
focal myositis
Humans
Immunosuppressive Agents - therapeutic use
Magnetic Resonance Imaging
Male
methotrexate
Methotrexate - therapeutic use
Muscle, Skeletal - pathology
Myositis - diagnostic imaging
Myositis - drug therapy
Myositis - pathology
nemaline
Prednisolone - therapeutic use
Recurrence
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Summary:This report describes a rare case of recurrent bilateral focal myositis and its successful treatment via methotrexate. A 38-year-old man presented myalgia of the right gastrocnemius in May 2005. Magnetic resonance imaging showed very high signal intensity in the right gastrocnemius on short-tau inversion recovery images. A muscle biopsy revealed inflammatory CD4+ cell-dominant myogenic change. Focal myositis was diagnosed. The first steroid treatment was effective. Tapering of prednisolone, however, repeatedly induced myositis relapse, which progressed to multiple muscle lesions of both lower limbs. Initiation of methotrexate finally allowed successful tapering of prednisolone, with no relapse in the past 4 years.
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Correspondence to Dr.　Hiroko Nagafuchi, h3naga@marianna-u.ac.jp
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.7172