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Makrophagische Myofasziitis vs. atypischer M. Whipple

Macrophagic myofascitis vs atypical Whipple’s disease

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Zusammenfassung

Ein 39-jähriger Mann entwickelte 8 Monate nach einer Tetanusimpfung diffuse Myalgien und zunehmende Schwäche. Histologisch fand sich eine Infiltration des Peri- und Endomysiums durch PAS-positive Makrophagen. Der Nachweis von Tropheryma whippelii im Blut und Stuhl in Abwesenheit intestinaler Beteiligung führte zunächst zu dem Verdacht auf einen atypischen M. Whipple mit isoliertem Muskelbefall. Der histologische Nachweis aluminiumhaltiger Makrophagen mittels Morin-Immunfluoreszenz sicherte letztendlich die Diagnose einer impfungsassoziierten makrophagischen Myofasziitis.

Summary

A 39-year-old man presented pronounced asthenia and diffuse myalgias 8 months after a vaccination against the tetanus toxoid. Muscle biopsy disclosed infiltration of the perimysium and endomysium by densely packed, PAS-positive macrophages. Tropheryma whippelii detection in blood and faeces allowed the initial assumption of atypical Whipple’s disease with isolated muscle involvement. However, the histological detection of aluminium-containing macrophages by means of Morin stain immunofluorescence established the diagnosis of macrophagic myofascitis in an obviously asymptomatic T. whippelii carrier.

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Authors and Affiliations

  1. Eginition Krankenhaus, Neurologische Universitätsklinik Athen, Vas. Sofias 72, 11528, Athen, Griechenland

    K. Spengos, A. Vontzalidis, S. Vassilopoulou & P. Manta

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  1. K. Spengos
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  2. A. Vontzalidis
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  3. S. Vassilopoulou
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  4. P. Manta
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Correspondence to K. Spengos.

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Spengos, K., Vontzalidis, A., Vassilopoulou, S. et al. Makrophagische Myofasziitis vs. atypischer M. Whipple. Nervenarzt 79, 1436–1439 (2008). https://doi.org/10.1007/s00115-008-2526-y

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  • DOI: https://doi.org/10.1007/s00115-008-2526-y

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