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Titolo:
DO NEUROMYOSITIS EXIST - 4 NEW CASES WITH AN ASSOCIATION TO HTLV-I INFECTION IN ONE
Autore:
LARAKI R; BLETRY O; AGBALIKA F; BOUCHE P; GODEAU P;
Indirizzi:
GRP HOSP PITIE SALPETRIERE,SERV MED INTERNE,83 BLVD HOP F-75651 PARIS13 FRANCE GRP HOSP PITIE SALPETRIERE,SERV EXPLORAT FONCT NEUROL F-75651 PARIS 13 FRANCE HOP ST LOUIS,VIROL LAB F-75010 PARIS FRANCE
Titolo Testata:
Annales de medecine interne
fascicolo: 2, volume: 145, anno: 1994,
pagine: 88 - 97
SICI:
0003-410X(1994)145:2<88:DNE-4N>2.0.ZU;2-R
Fonte:
ISI
Lingua:
FRE
Soggetto:
INCLUSION-BODY MYOSITIS; HUMAN IMMUNODEFICIENCY VIRUS; POLYMERASE CHAIN-REACTION; PERIPHERAL-NERVE; POLYMYOSITIS; DERMATOMYOSITIS; ANTIBODIES; MYELOPATHY; MUSCLE; MYOPATHY;
Keywords:
NEUROMYOSITIS; POLYMYOSITIS; NEUROPATHY; POLYRADICULONEURITIS; HTLV-I;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
58
Recensione:
Indirizzi per estratti:
Citazione:
R. Laraki et al., "DO NEUROMYOSITIS EXIST - 4 NEW CASES WITH AN ASSOCIATION TO HTLV-I INFECTION IN ONE", Annales de medecine interne, 145(2), 1994, pp. 88-97

Abstract

Neuromyositis defined as the association of dermatomyositis or polymyositis and a neuropathy without any found cause is a very controversial entity because of the possibility of, in one hand, muscular modifications caused by neurological involvement and, on the other hand, neurogenic type manifestations caused by polymyositis. The study of 4 casesseen in an Internal Medicine department and the review of the literature allowed us to show that the concept of neuromyositis corresponds to a clinico-pathological reality when the diagnosis is based on the association of definite criteria of both primary muscle and nerve involvement exclusing muscular abnormalities that could be the consequence of nerve involvement and vice versa. The criteria, most relevant when associated are : a) for muscular involvement : high increase of muscular enzyme over 6 times the superior limit of the normal values, pseudomyotonic electrical discharges, perifascicular atrophy, intense inflammatory infiltrates and massive necrosis, b) for neurological involvement: early abolition of tendinous reflexes in a patient without notable muscular atrophy and with little or no myalgia, sensitive abnormalities in areas other than those of muscular involvement, especially when they are intense, early weakness of distal muscles, decrease of nerve conduction speed, target fibers and lesions of nerve trunks (and albumino-cytological dissociation in the particular case of polyradiculoneuritis). Once the diagnosis of neuropathy settled, it is necessary to exclude an usual cause (alcoholism, diabetes...) before concluding to neuromyositis. When we apply these restrictive (but nervertheless necessary for the validity of diagnosis) criteria, only 6 cases of the literature respond to this entity. It is a peripheral neuropathy in 5 cases(like two of ours) and a polyradiculoneuritis in one case (like our two others). Among these 6 cases, there is a vasculitis in two, frequency much higher to what is observed in adult polymyositis, which suggest a possible causative role of vascular involvement in neuropathy arising. In the other cases we can just give pathogenic hypothesis making the neuropathy and the polymyositis the result of the same process (immunological disturbance, paraneoplastic origine, viral disease). In one of our four patients, who have shown an HTLV-I infection by polymerase chain reaction in situ hybridation was positive in muscle which suggest a direct pathogenic role of the virus. HTLV-I infection should beconsidered as a possible cause of neuromyositis especially in endemicareas.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 17:59:42