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Macrophagic myofasciitis associated with vaccine-derived aluminium

Meena Shingde, Roger Pamphlett, James Hughes, Ross Boadle and Edward J Wills
Med J Aust 2005; 183 (3): 145-146.

Macrophagic myofasciitis is characterised by sheets of macrophages in striated muscle, a few lymphocytes and inconspicuous muscle fibre damage. It is due to aluminium contained in vaccines, and is localised to the inoculation site. We report the first Australian case, detected incidentally when investigating a raised serum creatine kinase level.

Clinical record

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  • Meena Shingde1
  • Roger Pamphlett2
  • James Hughes3
  • Ross Boadle4
  • Edward J Wills5

  • 1 Department of Pathology, University of Sydney, Sydney, NSW.
  • 2 Tamworth, NSW.
  • 3 Electron Microscopy Unit, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, NSW.
  • 4 Central Sydney Electron Microscopy Unit, Concord Hospital, Concord, NSW.

Correspondence: 

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  • 2. Gherardi RK, Authier FJ. Aluminum inclusion macrophagic myofasciitis: a recently identified condition. Immunol Allergy Clin North Am 2003; 23: 699-712.
  • 3. Rimaniol AC, Gras G, Verdier F, et al. Aluminum hydroxide adjuvant induces macrophage differentiation towards a specialized antigen-presenting cell type. Vaccine 2004; 22: 3127-3135.
  • 4. Gherardi RK, Coquet M, Cherin P, et al. Macrophagic myofasciitis lesions assess long-term persistence of vaccine-derived aluminium hydroxide in muscle. Brain 2001; 124: 1821-1831.
  • 5. Nevo Y, Kutai M, Jossiphov J, et al. Childhood macrophagic myofasciitis-consanguinity and clinicopathological features. Neuromuscul Disord 2004; 14: 246-252.
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  • 7. Cherin P, Laforet P, Gherardi RK, et al. Macrophagic myofasciitis: description and etiopathogenic hypotheses. Rev Med Interne 1999; 20: 483-489.
  • 8. Authier FJ, Cherin P, Creange A, et al. Central nervous system disease in patients with macrophagic myofasciitis. Brain 2001; 124: 974-983.
  • 9. Cherin P, Menard D, Mouton P, et al. Macrophagic myofasciitis associated with inclusion body myositis: a report of three cases. Neuromuscul Disord 2001; 11: 452-457.
  • 10. Papo T. Macrophagic myofasciitis: focal or systemic? Joint Bone Spine 2003; 70: 242-245.

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