VACCINE

Neuromuscular Disorders • February 2004
Macrophagic myofasciitis:
an infantile Italian case
Author information
Di Muzio A1, 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
Abstract
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.
“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.”
http://www.ncbi.nlm.nih.gov/pubmed/?term=14733966