Di Muzio A, Capasso M, Verrotti A, Trotta D, Lupo S, Pappalepore N, Manzoli C, Chiarelli F, Uncini A
Center for Neuromuscular Diseases, University 'G. d'Annunzio', Chieti, Italy.
Neuromuscul Disord. 2004 Feb;14(2):175-7. doi: 10.1016/j.nmd.2003.09.007.
Macrophagic myofasciitis is a recently identified inflammatory myopathy mostly described in adult French patients complaining of arthro-myalgias and fatigue. It is probably due to intramuscular injection of aluminium-containing vaccines and is characterized by a typical muscular infiltrate of large macrophages with aluminium inclusions. We report a 1-year-old Italian child presenting irritability, delayed motor development, hyperCKemia (up to 10 times the normal value), and typical features of macrophagic myofasciitis on muscle biopsy. The child recovered fully after steroid therapy. Macrophagic myofasciitis is a new treatable cause of motor retardation and hyperCKemia in children, and is probably more common than reported. Diagnosis requires a high index of suspicion and can be missed if biopsy is performed outside the vaccination site.
巨噬细胞性肌炎是一种最近才被确认的炎症性肌病，多见于成年法国患者，他们常诉说有关节肌痛和疲劳。它可能是由于肌肉注射含铝疫苗所致，其特征是肌肉中有典型的含铝包涵体的大巨噬细胞浸润。我们报告了一名1岁的意大利儿童，表现为易怒、运动发育迟缓、高肌酸激酶血症（高达正常值的10倍），肌肉活检显示具有巨噬细胞性肌炎的典型特征。该患儿经类固醇治疗后完全康复。巨噬细胞性肌炎是儿童运动发育迟缓及高肌酸激酶血症的一种新的可治疗病因，可能比报道的更为常见。诊断需要高度怀疑，如果在疫苗接种部位以外进行活检可能会漏诊。
