Healy E G, Phadke R, Kidd M, Reilly M M, Lunn M P
Department of Molecular Neurosciences, UCL Institute of Neurology, MRC Centre for Neuromuscular Diseases, London, UK.
Division of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK.
Neuromuscul Disord. 2015 Jul;25(7):589-92. doi: 10.1016/j.nmd.2015.04.004. Epub 2015 Apr 16.
We report a rare case of myofasciitis and meningitis with deafness caused by systemic enterovirus infection in the setting of hypogammaglobulinaemia induced by rituximab. Whilst effective and generally safe, anti- CD 20 antibody therapy is increasingly recognised to result in unusual infectious complications to be considered in a treated patient presenting with neurological symptoms. These cases may pose diagnostic difficulties and can have atypical presentations. We present this rare complication of rituximab therapy, with histopathological confirmation of myofasciitis. In the older literature, enterovirus associated myofasciitis may have erroneously been termed dermatomyositis and we review the literature to demonstrate this important nosological point.
我们报告了一例罕见的肌筋膜炎和脑膜炎伴耳聋病例，病因是在利妥昔单抗诱导的低丙种球蛋白血症背景下发生的全身性肠道病毒感染。虽然抗CD20抗体治疗有效且总体安全，但人们越来越认识到，该治疗会导致不寻常的感染并发症，对于出现神经症状的接受治疗患者需要考虑这些并发症。这些病例可能会带来诊断困难，且表现可能不典型。我们展示了利妥昔单抗治疗的这一罕见并发症，并通过组织病理学证实了肌筋膜炎。在早期文献中，肠道病毒相关的肌筋膜炎可能被错误地称为皮肌炎，我们回顾文献以阐明这一重要的疾病分类要点。
