tacrolimus and Myofascial-Pain-Syndromes

Macrophagic myofascitis (MMF) is an unusual inflammatory myopathy characterized by muscle infiltration by macrophages and lymphocytes. Here, we describe a case of MMF which is associated with rheumatoid arthritis. A 53-year-old Japanese rheumatoid arthritis (RA) patient presented with focal tenderness of lower extremities. Magnetic resonance imaging showed evidence of myofascitis involving fascias of anterior tibialis muscle. Muscle biopsy showed a unique pathological pattern of MMF. MMF is known to be associated with vaccination containing aluminum. However, our case was not related to aluminum containing vaccinations and etiologies are unknown. The possible link needs to be discussed.

Topics: Arthritis, Rheumatoid; Biopsy; Fascia; Female; Gait Disorders, Neurologic; Humans; Immunosuppressive Agents; Leg; Macrophages; Magnetic Resonance Imaging; Middle Aged; Muscle Weakness; Muscle, Skeletal; Myofascial Pain Syndromes; Myositis; Prednisolone; Tacrolimus; Treatment Outcome