Nakagawa Y, Sakai I, Taneichi K, Shibaki H
Department of internal medicine, Kitami Red Cross Hospital, Hokkaido, Japan.
Ryumachi. 1996 Feb;36(1):58-61.
A sixty-year old woman had muscle pain of her extremities and stiffness in her fingers after unusual physical exertion. On admission she developed indurative swellings of the upper extremities and flexion contractures of her fingers. Laboratory data showed peripheral blood eosinophilia and excessive increase of muscle enzymes. Electromyography showed a myopathic pattern and magnetic resonance imaging showed findings of myositis. We performed a full thickness biopsy from skin to muscle. In histopathologic studies, collagenous hypertrophy of the fascia and perifascicular atrophy of muscle fibers and infiltrates on eosinophiles in the interstitial tissue were found. She was treated with prednisolone (60 mg/day). Clinical symptoms showed improvement and her peripheral blood eosinophiles and serum muscle enzymes deminished quickly. In this case, we suggest that the characteristic histopathologic findings in eosinophilic faciitis is not fascia alone, but includes muscle. We stress that eosinophilic faciitis and polymyositis are closely related.
一名60岁女性在进行不寻常的体力活动后出现四肢肌肉疼痛和手指僵硬。入院时，她出现上肢硬结性肿胀和手指屈曲挛缩。实验室数据显示外周血嗜酸性粒细胞增多和肌肉酶过度升高。肌电图显示肌病模式，磁共振成像显示肌炎表现。我们从皮肤到肌肉进行了全层活检。在组织病理学研究中，发现筋膜胶原性肥大、肌纤维束周萎缩以及间质组织中嗜酸性粒细胞浸润。她接受了泼尼松龙（60毫克/天）治疗。临床症状有所改善，外周血嗜酸性粒细胞和血清肌肉酶迅速减少。在这种情况下，我们认为嗜酸性筋膜炎的特征性组织病理学表现不仅限于筋膜，还包括肌肉。我们强调嗜酸性筋膜炎和多发性肌炎密切相关。
