Brain, Vol. 124, No. 9, 1821-1831,
September 2001
© 2001 Oxford University Press
Macrophagic myofasciitis lesions assess long-term persistence of vaccine-derived aluminium hydroxide in muscle
1 Equipe mixte INSERM E 0011/Université Paris XII (`Système neuromusculaire et inflammation'), Groupe NerfMuscle, Département de Pathologie, Hôpital Henri Mondor de l'Assistance Publique-Hôpitaux de Paris, Créteil 2 Unité de Myopathologie, Département d'Anatomie Pathologique, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux 3 Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière and 4 Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, 5 Centre d'Etudes Nucléaires de Bordeaux-Gradignan (URA 5797 du CNRS), Le Haut Vigneau, Université Bordeaux 1, Gradignan and 6 Laboratoire de Biopathologie Nerveuse et Musculaire (JE 2053, Université Aix-Marseille II), Faculté de Médecine, Marseille, France.
Correspondence to:
R.K. Gherardi (INSERM EI 0011), Département de Pathologie, Hôpital Henri Mondor, F-94010 Créteil Cedex, France E-mail: romain.gherardi@hmn.ap-hop-paris.fr
Macrophagic myofasciitis (MMF) is an emerging condition of unknown cause, detected in patients with diffuse arthromyalgias and fatigue, and characterized by muscle infiltration by granular periodic acidSchiff's reagent-positive macrophages and lymphocytes. Intracytoplasmic inclusions have been observed in macrophages of some patients. To assess their significance, electron microscopy was performed in 40 consecutive cases and chemical analysis was done by microanalysis and atomic absorption spectrometry. Inclusions were constantly detected and corresponded to aluminium hydroxide, an immunostimulatory compound frequently used as a vaccine adjuvant. A lymphocytic component was constantly observed in MMF lesions. Serological tests were compatible with exposure to aluminium hydroxide-containing vaccines. History analysis revealed that 50 out of 50 patients had received vaccines against hepatitis B virus (86%), hepatitis A virus (19%) or tetanus toxoid (58%), 396 months (median 36 months) before biopsy. Diffuse myalgias were more frequent in patients with than without an MMF lesion at deltoid muscle biopsy (P < 0.0001). Myalgia onset was subsequent to the vaccination (median 11 months) in 94% of patients. MMF lesion was experimentally reproduced in rats. We conclude that the MMF lesion is secondary to intramuscular injection of aluminium hydroxide-containing vaccines, shows both long-term persistence of aluminium hydroxide and an ongoing local immune reaction, and is detected in patients with systemic symptoms which appeared subsequently to vaccination.
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
H. Orbach and A. Tanay Vaccines as a trigger for myopathies Lupus, November 1, 2009; 18(13): 1213 - 1216. [Abstract] [PDF] |
||||
![]() |
M C Dalakas Toxic and drug-induced myopathies J. Neurol. Neurosurg. Psychiatry, August 1, 2009; 80(8): 832 - 838. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Lach and E. J. Cupler Macrophagic Myofasciitis in Children Is a Localized Reaction to Vaccination J Child Neurol, June 1, 2008; 23(6): 614 - 619. [Abstract] [PDF] |
||||
![]() |
C. Exley, G. Mamutse, O. Korchazhkina, E. Pye, S. Strekopytov, A. Polwart, and C. Hawkins Elevated urinary excretion of aluminium and iron in multiple sclerosis Multiple Sclerosis, September 1, 2006; 12(5): 533 - 540. [Abstract] [PDF] |
||||
![]() |
C. Fernandez, A. M. de Paula, D. Figarella-Branger, M. Krahn, R. Giorgi, B. Chabrol, M. -F. Monfort, J. Pouget, and J. -F. Pellissier Diagnostic evaluation of clinically normal subjects with chronic hyperCKemia Neurology, May 23, 2006; 66(10): 1585 - 1587. [Abstract] [Full Text] [PDF] |
||||
![]() |
F L Mastaglia Drug induced myopathies Practical Neurology, February 1, 2006; 6(1): 4 - 13. [Full Text] [PDF] |
||||
![]() |
J Sibilia and J F Maillefert Vaccination and rheumatoid arthritis Ann Rheum Dis, July 1, 2002; 61(7): 575 - 576. [Full Text] [PDF] |
||||






