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Seleem AA, Badr AH. Comparative study of the ciliary body and iris morphology in the anterior eye chamber of five different vertebrate classes. Anat Histol Embryol 2024; 53:e13052. [PMID: 38735035 DOI: 10.1111/ahe.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/27/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
One crucial component of the optical system is the ciliary body (CB). This body secretes the aqueous humour, which is essential to maintain the internal eye pressure as well as the clearness of the lens and cornea. The histological study was designed to provide the morphological differences of CB and iris in the anterior eye chambers of the following vertebrate classes: fish (grass carp), amphibians (Arabian toad), reptiles (semiaquatic turtle, fan-footed gecko, ocellated skink, Egyptian spiny-tailed lizard, Arabian horned viper), birds (common pigeon, common quail, common kestrel), and mammals (BALB/c mouse, rabbit, golden hamster, desert hedgehog, lesser Egyptian jerboa, Egyptian fruit bat). The results showed distinct morphological appearances of the CB and iris in each species, ranging from fish to mammals. The present comparative study concluded that the morphological structure of the CB and iris is the adaptation of species to either their lifestyle or survival in specific habitats.
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Affiliation(s)
- Amin A Seleem
- Biology Department, Faculty of Science, Taibah University, Al Madinah Almunawwarah, Saudi Arabia
- Zoology Department, Faculty of Science, Sohag University, Sohag, Egypt
| | - Amira H Badr
- Zoology Department, Faculty of Science, Sohag University, Sohag, Egypt
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Sharif K, Ben-Shabat N, Mahagna M, Shani U, Watad A, Cohen AD, Amital H. Inflammatory Bowel Diseases Are Associated with Polymyositis and Dermatomyositis-A Retrospective Cohort Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121727. [PMID: 36556929 PMCID: PMC9781532 DOI: 10.3390/medicina58121727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/19/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Background and Objectives: Polymyositis and dermatomyositis (PM/DM) are classified as polygenic autoimmune diseases, whereas inflammatory bowel disease (IBD) is considered a polygenic autoinflammatory disease. In the literature, several cases exist reporting the co-occurrence of both conditions. At the molecular level, PM/DM and IBD share common genetic determinants including interferon regulatory factor and vitamin D receptor susceptibility loci. Accumulating evidence underline several indicators that confer poor prognosis in IBD, including antinuclear antibody positivity and the presence of other autoimmune diseases, therefore the aim of this study is to assess the association between these entities. Materials and Methods: This is a population-based retrospective study using data retrieved from a large electronic medical record in Israel, the Clalit health registry. The sample included PM/DM patients and age- and sex-frequency matched controls. The prevalence of IBD in PM/DM was compared between the two groups and logistic regression was applied to control for confounding variables. Predictors of IBD in patients with PM/DM were also explored. Results: Our study included 12,278 subjects with 2085 PM/DM patients and 10,193 age- and sex- frequency-matched controls. The incidence of IBD in patients with PM/DM was significantly higher even after controlling for various confounding variables (OR of 1.73, 95% CI 1.05-2.86, p-value = 0.033). Anti-nuclear antibodies (ANA) positivity was found to be an independent predictor for IBD diagnosis in patients with PM/DM (OR 3.67, 95% CI 1.01-13.36, p = 0.048). Conclusion: Our analysis reports an association between IBD and PM/DM. Such association could point towards a common pathophysiological background. Further research is needed to further describe the clinical courses and whether a unique therapeutic approach is warranted.
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Affiliation(s)
- Kassem Sharif
- Department of Gastroenterology, Sheba Medical Centre, Tel-Hashomer 5265601, Israel
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Niv Ben-Shabat
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Muhammad Mahagna
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Uria Shani
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Abdulla Watad
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK
| | - Arnon D. Cohen
- Chief Physicians Office, Clalit Health Services, Tel Aviv 6209813, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | - Howard Amital
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
- Correspondence: ; Tel.: +972-3-5302661; Fax: +972-3-5304796
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Catherine J, Kadhim H, Lambot F, Liefferinckx C, Meurant V, Otero Sanchez L. Crohn’s disease-related ‘gastrocnemius myalgia syndrome’ successfully treated with infliximab: A case report. World J Gastroenterol 2022; 28:755-762. [PMID: 35317272 PMCID: PMC8891723 DOI: 10.3748/wjg.v28.i7.755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/13/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extra-intestinal manifestations in inflammatory bowel diseases (IBD) are frequent and involve virtually all organs. Conversely, the clinical characteristics and course of inflammatory myopathies in IBD remain poorly described and mostly related to orbital myositis. Moreover, alternative therapeutic strategies in non-responder patients to corticosteroid therapy must still be clarified.
CASE SUMMARY A 33-year-old woman with a history of unclassified colitis presented with acute bilateral calf pain. On admission, her clinical and biological examinations were non-specific. However, magnetic resonance imaging showed bilateral inflammatory changes in gastrocnemius muscles suggestive of myositis. Muscle biopsy confirmed the diagnosis of myositis and demonstrated an inflammatory infiltrate mainly located in the perimysial compartment including lympho-plasmocytic cells with the formation of several granulomatous structures while the endomysium was relatively spared. The combined clinical, biological and histomyopathological findings were concordant with the diagnosis of ‘gastrocnemius myalgia syndrome’ (GMS), a rare disorder associated with Crohn’s disease (CD). Ileocolonoscopy confirmed CD diagnosis and systemic corticosteroids (CS) therapy was started, resulting in a rapid clinical improvement. During CS tapering, however, she experienced a relapse of GMS together with a severe active ileocolitis. Infliximab was started and allowed a sustained remission of both conditions at the latest follow-up (20 mo).
CONCLUSION The GMS represent a rare CD-associated inflammatory myopathy for which anti-tumour necrosis factor-α therapy might be considered as an effective therapeutic option.
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Affiliation(s)
- Julien Catherine
- Institute for Medical Immunology, Université Libre de Bruxelles, Gosselies 6041, Belgium
- Department of Internal Medicine, C.U.B. Hôpital Erasme, Brussels 1070, Belgium
| | - Hazim Kadhim
- NeuroMyopathology Unit (Anatomic Pathology Service) and Reference Center for Neuromuscular Pathology, CHU Brugmann, Université Libre de Bruxelles, Brussels 1020, Belgium
| | - Frédéric Lambot
- Department of Internal Medicine, Centre Hospitalier Universitaire Tivoli, La Louvière 7100, Belgium
| | - Claire Liefferinckx
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, C.U.B. Hôpital Erasme, Brussels 1070, Belgium
- Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels 1070, Belgium
| | - Virginie Meurant
- Department of Emergency Medicine, Centre Hospitalier Universitaire Tivoli, La Louvière 7100, Belgium
| | - Lukas Otero Sanchez
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, C.U.B. Hôpital Erasme, Brussels 1070, Belgium
- Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels 1070, Belgium
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Affiliation(s)
- Eric M Drabble
- Department of SurgeryJohn Hunter Hospital, Lookout Road, New Lambton Heights, NSW 2305
| | - Jonathon S Gani
- Department of SurgeryJohn Hunter Hospital, Lookout Road, New Lambton Heights, NSW 2305
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Osada A, Yamada H, Takehara S, Tozuka Y, Fukushima T, Oka H, Okazaki H, Nagaoka S. Gastrocnemius Myalgia as a Rare Initial Manifestation of Crohn's Disease. Intern Med 2018; 57:2001-2006. [PMID: 29491286 PMCID: PMC6096017 DOI: 10.2169/internalmedicine.0327-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The initial symptoms of Crohn's disease (CD) sometimes present as extraintestinal lesions, which can be a diagnostic challenge for physicians. Painful legs, known as "gastrocnemius myalgia syndrome", are rare complications that often precede abdominal manifestations. We herein report the case of a 38-year-old man who presented with bilateral leg myalgia lasting for 4 months. Magnetic resonance imaging showed abnormal intensity, and a muscle biopsy revealed inflammatory cell infiltration. Abdominal symptoms appeared three months after the myalgia onset, and the diagnosis of CD was confirmed later by endoscopic and radiological findings. To our knowledge, this is the first description of gastrocnemius myalgia syndrome in Japan.
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Affiliation(s)
- Atsumu Osada
- Department of Rheumatology, Yokohama Minami Kyosai Hospital, Japan
| | - Hiroaki Yamada
- Department of Gastroenterology, Kosinkai Shiomidai Hospital, Japan
| | - Sayuri Takehara
- Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Japan
| | | | - Taito Fukushima
- Department of Gastroenterology, Kanagawa Cancer Center, Japan
| | - Hiroyuki Oka
- Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Japan
| | - Hiroshi Okazaki
- Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Japan
| | - Shohei Nagaoka
- Department of Rheumatology, Yokohama Minami Kyosai Hospital, Japan
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Yamamoto M, Inoue M, Tachibana N, Tsuzaki K, Shibata Y, Hamano T. [Non-granulomatous myositis in a patient with ulcerative colitis who showed symptoms resembling gastrocnemius myalgia syndrome]. Rinsho Shinkeigaku 2017; 57:71-76. [PMID: 28132973 DOI: 10.5692/clinicalneurol.cn-000891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The patient was a 36-year-old man. His initial symptom was bilateral thigh and calf pain. When he developed ulcerative colitis in the following year, he also noticed wasting of the calf muscles. The clinical feature is similar to gastrocnemius myalgia syndrome, although the left upper limb was also involved. A high-intensity lesion in the left calf and soleus muscles was observed on MRI, which was lead to the diagnosis of non-granulomatous myositis with infiltration of CD68-positive cells based on muscle biopsy. After steroids were administered, his pain subsided. Evaluation with needle EMG, MRI, and muscle biopsy is important when muscle pain accompanies inflammatory bowel disease.
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Vadala di Prampero S, Marino M, Toso F, Avellini C, Nguyen V, Sorrentino D. Isolated Bilateral Gastrocnemius Myositis in Crohn Disease Successfully Treated with Adalimumab. Case Rep Gastroenterol 2016; 10:661-667. [PMID: 27920658 PMCID: PMC5126597 DOI: 10.1159/000448880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 08/01/2016] [Indexed: 12/25/2022] Open
Abstract
Extraintestinal manifestations are common in inflammatory bowel disease; however, muscular involvement in Crohn disease is rarely reported. We present a case of a 26-year-old male with ileocolonic Crohn disease who developed sudden tenderness in both calves. Doppler ultrasound was negative for deep vein thrombosis. Magnetic resonance imaging of the gastrocnemius muscle showed high intensity signal in the muscle fibers, and muscle biopsy demonstrated nonspecific lymphocytic myositis. Other relevant laboratory results included normal antineutrophil cytoplasmic antibodies and creatine kinase as well as elevated C-reactive protein, erythrocyte sedimentation rate, and anti-Saccharomyces cerevisiae IgG titer. The patient was in clinical remission, being treated with azathioprine 2.5 mg/kg. Prednisone 60 mg/day was initiated with rapid resolution of calf tenderness; however, tenderness soon returned when the dose was tapered to 10 mg/day. Subsequently, prednisone and azathioprine were discontinued, and adalimumab was started at standard induction and maintenance doses. The patient's symptoms resolved shortly after the first induction dose. A repeat magnetic resonance imaging of the calves – 3 months after starting adalimumab – showed complete resolution of muscle inflammation. To our knowledge, this is the first case of gastrocnemius myositis – a rare extraintestinal manifestation of Crohn disease – successfully treated with anti-tumor necrosis factor agents.
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Affiliation(s)
| | - Marco Marino
- Department of Pathology, University Hospital of Udine, Udine, Italy
| | - Francesco Toso
- Department of Pathology, University Hospital of Udine, Udine, Italy
| | - Claudio Avellini
- Department of Pathology, University Hospital of Udine, Udine, Italy
| | - Vu Nguyen
- Department of Internal Medicine. Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Dario Sorrentino
- Department of Pathology, University Hospital of Udine, Udine, Italy; Department of Internal Medicine. Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Department of Clinical and Experimental Medical Sciences, University of Udine School of Medicine, Udine, Italy
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The concurrent association of inflammatory polymyositis and Crohn's ileo-colitis in a Sri Lankan man: a case report of a rare association and literature review. BMC Gastroenterol 2014; 14:35. [PMID: 24552185 PMCID: PMC3938905 DOI: 10.1186/1471-230x-14-35] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 02/17/2014] [Indexed: 12/12/2022] Open
Abstract
Background Crohn’s disease is a relapsing, systemic inflammatory disease affecting the gastrointestinal tract with associated extraintestinal manifestations and immune disorders. Among the few cases reported, the association of Crohn’s disease with polymyositis varies in its complexity and severity. We report here the first known case of inflammatory polymyositis leading to rhabdomyolysis in a male patient diagnosed with Crohn’s ileocolitis. Case presentation A 42-year-old previously healthy man presented with acute polymyositis leading to rhabdomyolysis. The acute nature of the illness raised the suspicion of an infective, toxic, or metabolic insult, which was excluded during further investigations. Prolonged low-grade fever and raised inflammatory markers led to the suspicion of inflammatory polymyositis, which was confirmed by electromyography and muscle histology. In the absence of an infective cause, the concurrent association of prolonged diarrhea containing blood and mucous after recovery from an acute phase of myositis proved a diagnostic challenge. Ileocolonoscopy findings of extensive aphthous ulceration with skip lesions extending to the terminal ileum, and histology showing polymorph infiltration of the lamina propria, transmural involvement, and micro abscess formation was suggestive of Crohn’s disease. Sensory motor axonal peripheral neuropathy, which is another rare association of inflammatory bowel disease, was also present. Conclusion An unrecognized genetic predisposition or altered gut permeability causing disruption of the gut immune barrier triggering an immune response against skeletal muscles may have contributed to this unique association. Both polymyositis and Crohn’s ileocolitis responded well to corticosteroids and azathioprine, which is supportive of their immune pathogenesis. Myositis can be considered to be a rare extraintestinal manifestation of Crohn’s disease and can be used in the differential diagnosis of corticosteroid or hypokalemia-induced myopathy in Crohn’s disease.
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Zois CD, Katsanos KH, Kosmidou M, Tsianos EV. Neurologic manifestations in inflammatory bowel diseases: current knowledge and novel insights. J Crohns Colitis 2010; 4:115-24. [PMID: 21122494 DOI: 10.1016/j.crohns.2009.10.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Crohn's disease (CD) and ulcerative colitis (UC), widely known as inflammatory bowel diseases (IBD), are thought to result from an inappropriate activation of the mucosal immune system driven by intestinal bacterial flora. METHODS Although the extraintestinal manifestations of IBD are well documented, the association of IBD with neurologic and neuromuscular involvement is rare and often controversial, with sporadic and conflicting data on its prevalence and spectrum. In addition, a serious number of the latter manifestations may become life-threatening, playing a very important role in disease morbidity. To define the pattern of neurologic involvement in IBD, the most important manifestations in these patients have been reviewed, exploring also their clinical significance. RESULTS There is evidence that UC and CD can manifest both in the PNS and CNS. Thrombotic complications are common in IBD patients, but cerebral vascular involvement is rare. CONCLUSIONS Neurologic manifestations in IBD patients are more common than previously estimated and may follow a different pattern of involvement in CD and UC. Small numbers of patients currently preclude a better characterization of the clinical spectrum and a better understanding of pathogenesis.
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Affiliation(s)
- Christos D Zois
- 1st Department of Internal Medicine, Hepato-Gastroenterology Unit, Medical School, University of Ioannina, 451 10 Ioannina, Greece
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Bourikas LA, Papadakis KA. Musculoskeletal manifestations of inflammatory bowel disease. Inflamm Bowel Dis 2009; 15:1915-24. [PMID: 19408334 DOI: 10.1002/ibd.20942] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Accepted: 02/25/2009] [Indexed: 01/14/2023]
Abstract
Extraintestinal manifestations develop in ≈25% of patients with inflammatory bowel disease (IBD). Musculoskeletal symptoms are the most common extraintestinal manifestations of IBD, often associated with colonic involvement, and present as either articular (arthritis) or periarticular inflammation including enthesitis, myositis, or soft tissue rheumatism (fibromyalgia). Musculoskeletal manifestations can precede or be synchronous with the development of bowel disease or develop following the diagnosis of IBD. Their clinical course often correlates with IBD activity but it can also be independent of the activity of bowel disease. Controlling intestinal inflammation remains the cornerstone therapeutic approach for the musculoskeletal manifestations of IBD.
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Affiliation(s)
- Leonidas A Bourikas
- Department of Gastroenterology, University Hospital of Heraklion, University of Crete Medical School, Crete, Greece
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Shimoyama T, Tamura Y, Sakamoto T, Inoue K. Immune-mediated myositis in Crohn's disease. Muscle Nerve 2009; 39:101-5. [DOI: 10.1002/mus.21164] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Qureshi JA, Staugaitis SM, Calabrese LH. Neutrophilic myositis: an extra-intestinal manifestation of ulcerative colitis. J Clin Rheumatol 2007; 8:85-8. [PMID: 17041328 DOI: 10.1097/00124743-200204000-00004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Myositis of the skeletal muscle is rarely seen as an extraintestinal manifestation of inflammatory bowel disease. We report a case of a 36-year-old man with ulcerative colitis who developed 3 episodes of steroid responsive myositis in a 4-month period. He presented with a blistering rash followed by pain and massive swelling in the right shoulder and lower extremities, with marked elevation in muscle enzymes. Diagnosis of myositis was made after a muscle biopsy, which showed neutrophilic infiltrate in the deep subcutaneous tissue and skeletal muscle. Review of the literature indicates only a few cases of myositis associated with ulcerative colitis, most of them during an acute exacerbation of the disease. However, the present patient had his first episode when the ulcerative colitis was in remission. Myositis in ulcerative colitis may present atypically, in particular mimicking pyomyositis. Clinicians should be aware of this unusual steroid-sensitive complication.
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Affiliation(s)
- Jazibeh A Qureshi
- Department of Rheumatic and Immunologic Disease, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Paoluzi OA, Crispino P, Rivera M, Iacopini F, Palladini D, Consolazio A, Paoluzi P. Skeletal muscle disorders associated with inflammatory bowel diseases: occurrence of myositis in a patient with ulcerative colitis and Hashimoto's thyroiditis--case report and review of the literature. Int J Colorectal Dis 2006; 21:473-7. [PMID: 16205931 DOI: 10.1007/s00384-005-0035-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2005] [Indexed: 02/04/2023]
Abstract
Ulcerative colitis (UC) and Crohn's disease are inflammatory bowel diseases often associated with extra-intestinal manifestations. Of these, neutrophilic dermatoses and arthropathies are the more frequently observed, while the occurrence of striated muscle disorders, namely, myositis, has been very rarely diagnosed in these kinds of patients. The coexistence of immuno-mediated diseases in patients with inflammatory bowel diseases and myositis suggests a common aetiopathogenetic mechanism underlying these conditions. The present report refers to a rare case of a 51-year-old female with UC and Hashimoto's thyroiditis who developed myositis.
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Affiliation(s)
- Omero Alessandro Paoluzi
- U.O. di Gastroenterologia ed Endoscopia Digestiva, Poliambulatorio Don Bosco ASL RMB, Via Antistio 15, 00174, Rome, Italy.
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Affiliation(s)
- R M Hoffmann
- Ev. Krankenhaus Kalk, Akad. Lehrkrankenhaus der Universität zu Köln, Buchforststr. 2 D-51103 Köln
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Abstract
An elderly woman with chronic ulcerative colitis who developed proximal muscle weakness, increased serum creatine phosphokinase activity, and histological and electromyographic abnormalities characteristic of polymyositis is described. Treatment with corticosteroids and 5-acetylsalicylic acid was followed by a remission in bowel symptoms, improvement in muscle power, and reversal of electromyographic changes. An autoimmune link between the two disorders seems likely.
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Affiliation(s)
- S Chugh
- Department of Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Amongst the protean extra-intestinal manifestations of inflammatory bowel disease, scant mention is made of muscle involvement. This report outlines the clinical features, electrodiagnostic and muscle biopsy findings in a patient with ulcerative colitis who developed progressive proximal muscle weakness. The demonstration of interstitial myositis is discussed in relation to his underlying disease.
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Affiliation(s)
- A I Bhigjee
- Dept. of Medicine, Wentworth Hospital, Jacobs, South Africa
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