MyMedR

Eosinophilia and musculoskeletal disease

Watts RA

Curr Opin Rheumatol, 2001 Jan;13(1):57-61.

Eosinophilia is occasionally a feature of rheumatic disease. The differential diagnosis of eosinophilia includes parasitic infection, systemic vasculitides, eosinophilic arthritis, and myopathies, together with the idiopathic hypereosinophilic syndrome and malignancy. Careful evaluation of the patient should enable an accurate diagnosis to be made. Parasitic infection is the commonest cause of eosinophilia worldwide and can cause systemic disease, as illustrated by the report of Sarcocystis myositis in a group of military personnel in Malaysia. A persistent arthropathy associated with eosinophilia, but not with parasitic infection, has been reported from the far East. Drugs may also cause eosinophilia, and there has recently been much discussion of the relation between Churg-Strauss syndrome and the leukotriene antagonist zafirlukast. The present view is that reduction of steroid dose allows unmasking of previously undiagnosed Churg-Strauss syndrome. The idiopathic hypereosinophilic syndrome may represent a lymphoproliferative process; evidence for this comes from the demonstration that many patients have a clonally expanded population of aberrant T cells.

Matched MeSH terms: Muscular Diseases

Fulltext Mechanomyographic parameter extraction methods: an appraisal for clinical applications

Ibitoye MO, Hamzaid NA, Zuniga JM, Hasnan N, Wahab AK

Sensors (Basel), 2014;14(12):22940-70.

PMID: 25479326 DOI: 10.3390/s141222940

The research conducted in the last three decades has collectively demonstrated that the skeletal muscle performance can be alternatively assessed by mechanomyographic signal (MMG) parameters. Indices of muscle performance, not limited to force, power, work, endurance and the related physiological processes underlying muscle activities during contraction have been evaluated in the light of the signal features. As a non-stationary signal that reflects several distinctive patterns of muscle actions, the illustrations obtained from the literature support the reliability of MMG in the analysis of muscles under voluntary and stimulus evoked contractions. An appraisal of the standard practice including the measurement theories of the methods used to extract parameters of the signal is vital to the application of the signal during experimental and clinical practices, especially in areas where electromyograms are contraindicated or have limited application. As we highlight the underpinning technical guidelines and domains where each method is well-suited, the limitations of the methods are also presented to position the state of the art in MMG parameters extraction, thus providing the theoretical framework for improvement on the current practices to widen the opportunity for new insights and discoveries. Since the signal modality has not been widely deployed due partly to the limited information extractable from the signals when compared with other classical techniques used to assess muscle performance, this survey is particularly relevant to the projected future of MMG applications in the realm of musculoskeletal assessments and in the real time detection of muscle activity.

Matched MeSH terms: Muscular Diseases/diagnosis; Muscular Diseases/physiopathology*

Relapsing retroperitoenal abscess secondary to juvenile dermatomyositis: Complexity in management

Jothinathan M, Lau KS, Vanusha D

Med J Malaysia, 2020 03;75(2):178-180.

PMID: 32281605

Juvenile dermatomyositis (JDM) is a systemic autoimmune condition with myopathy. Gastrointestinal and pulmonary manifestations are rare presentation of JDM. Gastrointestinal perforation incidence in JDM is associated with vasculopathy and ischaemia. There are only few reported case of management of JDM with gastrointestinal complication. Management of such condition is challenging. We present a 21-year-old man with spontaneous descending colon perforation undergoing Hartmann's procedure. He subsequently presented with recurrent retroperitoneal abscess at five and 30 months following the initial presentation which was treated with percutaneous drainage. A high index of suspicion is necessary in JDM patients presenting with acute abdomen.

Matched MeSH terms: Muscular Diseases

Pharmacological evaluation of vanillic acid in rotenone-induced Parkinson's disease rat model

Sharma N, Khurana N, Muthuraman A, Utreja P

Eur J Pharmacol, 2021 Jul 15;903:174112.

PMID: 33901458 DOI: 10.1016/j.ejphar.2021.174112

In the present study, we investigated the anti-Parkinson's effect of vanillic acid (VA) (12 mg/kg, 25 mg/kg, 50 mg/kg p.o.) against rotenone (2 mg/kg s.c.) induced Parkinson's disease (PD) in rats. The continuous administration of rotenone for 35 days resulted in rigidity in muscles, catalepsy, and decrease in locomotor activity, body weight, and rearing behaviour along with the generation of oxidative stress in the brain (rise in the TBARS, and SAG level and reduced CAT, and GSH levels). Co-treatment of VA and levodopa-carbidopa (100 mg/kg + 25 mg/kg p.o.) lead to a significant (P

Matched MeSH terms: Muscular Diseases/chemically induced; Muscular Diseases/drug therapy

Myopathic dropped head syndrome: a syndrome of mixed aetiology

Goh KJ, Wong KT, Tan CT

J Clin Neurosci, 2000 Jul;7(4):334-6.

PMID: 10938615

We report two patients with myopathic dropped head syndrome, a rare and interesting neuromuscular syndrome characterised by a predominant weakness of the neck extensor muscles. The first patient, a middle aged Chinese man, presented with progressive weakness of neck extension but his clinical course later stabilised despite a lack of response to corticosteroids. Muscle biopsy revealed a necrotising myopathy with no evidence of inflammation. This patient supports the existence of an idiopathic restricted non-inflammatory myopathy, a so called isolated neck extensor myopathy syndrome which is recognised to pursue a less progressive, more benign course. Our second patient had histopathological evidence for polymyositis; there was a favourable response to steroids. Our cases underscore the fact that there may be a spectrum of pathological processes associated with the myopathic dropped head syndrome ranging from non-inflammatory muscle necrosis to a full blown inflammatory myositis.

Matched MeSH terms: Muscular Diseases/complications*; Muscular Diseases/pathology*; Muscular Diseases/physiopathology

Characterization of Statin-Associated Myopathy Case Reports in Thailand Using the Health Product Vigilance Center Database

Boonmuang P, Nathisuwan S, Chaiyakunapruk N, Suwankesawong W, Pokhagul P, Teerawattanapong N, et al.

Drug Saf, 2013 Sep;36(9):779-87.

PMID: 23615756 DOI: 10.1007/s40264-013-0055-5

HMG-CoA reductase inhibitors [statins], a widely prescribed cholesterol-lowering therapy, are associated with muscle-related adverse events. While characteristics of such events are well documented in Western countries, little data exists for the Thai population.

Matched MeSH terms: Muscular Diseases/chemically induced*; Muscular Diseases/epidemiology

Musculoskeletal lesions in yaws

Sengupta S

Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.

PMID: 3967422

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.

Matched MeSH terms: Muscular Diseases/etiology*

Fulltext Cerebrotendinous xanthomatosis with cholestanolaemia--involvement of five individuals in a Malay family

Othman NH, Rahman SA

Med J Malaysia, 1990 Dec;45(4):275-80.

PMID: 2152046

Cerebrotendinous xanthomatosis (CTX), a rare inherited lipid storage disease is due to a defect in bile acid metabolism. Involvement of five members of a family is presented. The clinical features, laboratory and pathologic findings are discussed. Tendinous and tuberous xanthomatosis, bilateral cataracts, cerebral impairment and raised serum cholestanol are the salient features. We believe this is the first report of CTX in Malaysia.

Matched MeSH terms: Muscular Diseases/genetics; Muscular Diseases/pathology

Fulltext SLE/ polymyositis overlap syndrome

Seng, Wee Cheo, Rosdina Zamrud Ahmad Akbar, Tee, Tat Khoo, Kuo, Zhau Teo, Carwen Siaw, Qin, Jian Low

Borneo Journal of Medical Sciences, 2020;14(3):33-38.

MyJurnal

Inflammatory myopathies (IM) is a rare inflammatory muscle disorder, which can be broadly divided into 5 subgroups. The accurate diagnosis of subtype of IM can be challenging due to a diverse presentation of the disease. On the other hand, skeletal muscle complication is common in patients with systemic lupus erythematosus (SLE) in the form of myalgia or myopathy. Inflammatory myopathy is a rare association of SLE and the diagnosis and treatment can be quite challenging. A 43-year-old lady with underlying systemic lupus erythematosus (SLE), presented with subacute onset progressively worsening muscle weakness involving upper limbs and lower limbs. Neurological examination showed findings consistent with proximal myopathy, with proximal power of 3/5 and distal power of 4/5. She has elevated creatinine kinase, ALT and AST level. Her myositis-specific autoantibodies were positive for anti-Ku antibodies. Her electromyography showed evidence of active myopathy of the upper and lower limb. Here, we would like to report a case of polymyositis in a patient with SLE.

Matched MeSH terms: Muscular Diseases

Melioidosis, the great mimicker: a report of 10 cases from Malaysia

Yee KC, Lee MK, Chua CT, Puthucheary SD

J Trop Med Hyg, 1988 Oct;91(5):249-54.

PMID: 3184245

Between 1981 and 1986, 10 consecutive cases of melioidosis were seen at the University Hospital, Kuala Lumpur, Malaysia. They illustrate the amazing guises of melioidosis presenting as: abscesses of the supraspinatus muscle, psoas muscle, brain and liver; three different pulmonary forms; an acute suppurative dermal lesion; an acute septicaemia; and chronic lymphadenitis. The majority had underlying diseases: diabetes mellitus, the commonest, was present in six, out of whom three had previous pulmonary tuberculosis; other predisposing conditions were renal failure, corticosteroid therapy and malnutrition. Three patients who died had pre-existing renal impairment and developed renal failure later, suggesting that the former is a bad prognostic sign. Clinical diagnosis was difficult: all cases were diagnosed bacteriologically. A high level of clinical awareness is necessary, especially when presentation simulates pulmonary or extrapulmonary tuberculosis in patients with diabetes or other compromised states.

Matched MeSH terms: Muscular Diseases*

Myocysticercosis of the Masseter Muscle

Nath S, Prajapati VK, Pulikkotil SJ

J Coll Physicians Surg Pak, 2019 Feb;29(2):196.

PMID: 30700369 DOI: 10.29271/jcpsp.2019.02.196

Matched MeSH terms: Muscular Diseases/drug therapy; Muscular Diseases/parasitology

Sarcocystis myopathy in a patient with HIV-AIDS

Anderson D, Nathoo N, Lu JQ, Kowalewska-Grochowska KT, Power C

J Neurovirol, 2018 06;24(3):376-378.

PMID: 29508303 DOI: 10.1007/s13365-018-0620-x

Sarcocystosis is a zoonotic infection that causes intestinal and muscular illnesses in humans. Sarcocystosis was until recently considered rare in humans. To complete their life cycle, Sarcocystis species require both a definitive and an intermediate host. Humans are the definitive host when infected by one of two species: Sarcocystis hominis (from eating undercooked beef) or Sarcocystis suihominis (from eating uncooked pork). Infection with either of these species results in intestinal sarcocystosis, causing a self-limited disease characterized by nausea, abdominal pain, and diarrhea. Humans act as the intermediate host when infected by Sarcocystis nesbitti, resulting in the markedly different clinical picture of muscular sarcocystosis. Most documented cases of muscular sarcocystosis were assumed to be acquired in Malaysia, in addition to other regions of Southeast Asia and India. Published cases of muscular sarcocystosis from the Middle East, Central and South America, and Africa are all rare. Although the clinical presentation of muscular sarcocystosis remains to be fully characterized, fever, myalgia, and headache are among the most common symptoms. Here, we report a patient from sub-Saharan Africa with chronic Sarcocystis myopathy and well-controlled HIV-AIDS.

Matched MeSH terms: Muscular Diseases

Sarcocystis booliati n.sp. and a parasite of undetermined taxonomic position, Octoplasma garnhami n. gen. n. sp., from the moonrat, Echinosorex gymnurus

Dissanaike AS, Poopalachelvam M

Southeast Asian J. Trop. Med. Public Health, 1975 Jun;6(2):175-85.

PMID: 809845

Sarcocystis booliati n.sp. is described from the moonrat Echinosorex gymnurus (Mammalia, Insectivora) from West Malaysia. The cysts are very thin-walled, not visible to the naked eye, and have no trabeculae or cytophaneres. They are found in skeletal but not heart muscle. The zoites are small, 5-8 by 2-3 mum with a mean of 6.5 by 2.2 mum, in dry fixed smears. Octoplasma garnhami n.gen. n.sp., a parasite of undetermined taxonomic status but belonging to the Coccidiasina, Apicomplexa, is also described from the same host. Only schizononts and pseudocysts with typically 8 zoites, have so far been seen in monocytes of the spleen and liver. The zoites are large, 15 by 3 mum and have a distinct nucleolus even in dry-fixed smears.

Matched MeSH terms: Muscular Diseases/parasitology

Human muscular sarcocystosis in Malaysia

Wong KT, Pathmanathan R

Trop Geogr Med, 1993;45(4):191.

PMID: 8236476

Matched MeSH terms: Muscular Diseases/complications; Muscular Diseases/epidemiology*

High prevalence of human skeletal muscle sarcocystosis in south-east Asia

Wong KT, Pathmanathan R

Trans R Soc Trop Med Hyg, 1992 11 1;86(6):631-2.

PMID: 1287922

The prevalence of human skeletal muscle sarcocystosis in Malaysia was determined by serial examination of formalin-fixed, paraffin-embedded sections of tongue tissues obtained from consecutive, routine autopsies of subjects aged 12 years or more. Of 100 tongues examined, 21% were found to contain Sarcocystis; 66 cysts were found. The number of cysts per case varied from 1 to 13. In one case, 5 cysts were found in a single tissue section. The age range of positive cases was from 16 to 57 years (mean 37.7 years). Prevalence did not differ with regard to race, sex or occupation. The prevalence of human muscular sarcocystosis in our study was higher than that reported elsewhere. Preferential localization of Sarcocystis in tongue or head and neck and/or genuinely high prevalence in south-east Asia are possible explanations for this observation.

Matched MeSH terms: Muscular Diseases/epidemiology*; Muscular Diseases/parasitology

Fulltext Review of sarcocystosis in Malaysia

Kan SP, Pathmanathan R

Southeast Asian J. Trop. Med. Public Health, 1991 Dec;22 Suppl:129-34.

PMID: 1822870

Sarcocystis is a tissue coccidian with an obligatory two-host life cycle. The sexual generations of gametogony and sporogony occur in the lamina propria of the small intestine of definitive hosts which shed infective sporocysts in their stools and present with intestinal sarcocystosis. Asexual multiplication occurs in the skeletal and cardiac muscles of intermediate hosts which harbor Sarcocystis cysts in their muscles and present with muscular sarcocystosis. In Malaysia, Sarcocystis cysts have been reported from many domestic and wild animals, including domestic and field rats, moonrats, bandicoots, slow loris, buffalo, and monkey, and man. The known definitive hosts for some species of Sarcocystis are the domestic cat, dog and the reticulated python. Human muscular sarcocystosis in Malaysia is a zoonotic infection acquired by contamination of food or drink with sporocysts shed by definitive hosts. The cysts reported in human muscle resembled those seen in the moonrat, Echinosorex gymnurus, and the long-tailed monkey, Macaca fascicularis. While human intestinal sarcocystosis has not been reported in Malaysia so far, it can be assumed that such cases may not be infrequent in view of the occurrence of Sarcocystis cysts in meat animals, such as buffalo. The overall seroprevalence of 19.8% reported among the main racial groups in Malaysia indicates that sarcocystosis (both the intestinal and muscular forms) may be emerging as a significant food-borne zoonotic infection in the country.

Matched MeSH terms: Muscular Diseases/epidemiology*

Fulltext Necrotizing autoimmune myopathy: a case series

Narisa Sulaiman Sahari, Abdul Aziz Marwan, Dayang Masyrinartie Suahilai, Nurulraziquin Mohd Jamid, Nor Shuhaila Shahril

Malaysian Journal of Medicine and Health Sciences, 2020;16(108):78-80.

MyJurnal

Necrotizing autoimmune myopathy (NAM) is considered a new subgroup of a rare autoimmune idiopathic inflam- matory myopathies. Classically, NAM presented with sub-acute onset of proximal muscle loss of power with raised creatinine kinase and characteristic muscle biopsy showing muscle necrosis and regeneration with little inflamma- tion. Statin use, connective tissue diseases, malignancy and HIV infection are the identified risk factors for NAM. The autoantibodies expected to be presented in NAM are anti-signal recognition particle (SRP) and anti-hydroxymethylgl- utaryl-coenzyme A reductase (anti-HMGCR) antibodies. In this article, we present three cases of NAM with different risk factors and autoantibodies which we believe to have impact on the clinical course and outcome of our patients

Matched MeSH terms: Muscular Diseases

Fulltext Draft Genome Sequence of Streptococcus anginosus Strain CALM001, Isolated from the Gut of an Elderly Dane

Ahmad HF, Schreiber L, Marshall IPG, Andersen PJ, Castro-Mejía JL, Nielsen DS

Microbiol Resour Announc, 2019 Jun 13;8(24).

PMID: 31196919 DOI: 10.1128/MRA.00379-19

Here, we present a 1.89-Mbp draft genome sequence of Streptococcus anginosus strain CALM001, a Gram-positive bacterium that was isolated from a fecal sample donated by a 70-year-old Dane enrolled in the Counteracting Age-Related Loss of Skeletal Muscle Mass (CALM) intervention study.

Matched MeSH terms: Muscular Diseases

Statin intolerance: an updated, narrative review mainly focusing on muscle adverse effects

Li JJ, Liu HH, Wu NQ, Yeo KK, Tan K, Ako J, et al.

Expert Opin Drug Metab Toxicol, 2020 Sep;16(9):837-851.

PMID: 32729743 DOI: 10.1080/17425255.2020.1802426

INTRODUCTION: Statins have been established as the standard of care for dyslipidemia and preventing cardiovascular diseases while posing few safety concerns. However, misconceptions about statin intolerance lead to their underuse, indicating a need to improve the understanding of the safety of this treatment.

AREAS COVERED: We searched PubMed and reviewed literatures related to statin intolerance published between February 2015 and February 2020. Important large-scale or landmark studies published before 2015 were also cited as key evidence.

EXPERT OPINION: Optimal lowering of low-density lipoprotein cholesterol with statins substantially reduces the risk of cardiovascular events. Muscle adverse events (AEs) were the most frequently reported AEs by statin users in clinical practice, but they usually occurred at a similar rate with statins and placebo in randomized controlled trials and had a spurious causal relationship with statin treatment. We proposed a rigorous definition for identifying true statin intolerance and present the criteria for defining different forms of muscle AEs and an algorithm for their management. True statin intolerance is uncommon, and every effort should be made to exclude false statin intolerance and ensure optimal use of statins. For the management of statin intolerance, statin-based approaches should be prioritized over non-statin approaches.

Matched MeSH terms: Muscular Diseases/chemically induced*; Muscular Diseases/diagnosis

Fulltext Giant epidermal cyst with intramuscular extension: a rare occurrence

Low SF, Sridharan R, Ngiu CS

BMJ Case Rep, 2015 Feb 06;2015.

PMID: 25661748 DOI: 10.1136/bcr-2013-202534

An epidermal cyst is the most common type of cyst to occur in subcutaneous tissue. When its size is greater than 5 cm, it is recognised as a giant epidermal cyst. A subcutaneous giant epidermal cyst with intramuscular extension is extremely rare. The authors report a case of a 74-year-old man who presented with a painless, slow-growing left gluteal mass of 6-month duration. Examination revealed a large left gluteal mass that was fixed to the underlying structures. A small epidermal cyst with visible punctum was noted at the medial aspect of the mass. MRI demonstrated a large, lobulated left gluteal lesion measuring 20 cm×16 cm×10 cm. The lesion was partly within the gluteal maximus muscle and partly within the subcutaneous tissue. MRI and ultrasound features of the lesion were consistent with a giant epidermal cyst with intramuscular extension. The lesion was excised and histology confirmed the diagnosis.

Matched MeSH terms: Muscular Diseases/diagnosis*

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