PMID- 32710199
OWN - NLM
STAT- MEDLINE
DCOM- 20210607
LR  - 20210607
IS  - 1437-160X (Electronic)
IS  - 0172-8172 (Linking)
VI  - 40
IP  - 10
DP  - 2020 Oct
TI  - Clinical characteristics of patients with myalgia as the initial manifestation of 
      small and medium-sized vasculitis: a retrospective study.
PG  - 1667-1674
LID - 10.1007/s00296-020-04652-y [doi]
AB  - Myalgia is a common symptom in small and medium-sized systemic vasculitis, 
      sometimes occurring as the initial or only clinical manifestation of vasculitis. 
      This study investigated the clinical features and diagnostic process in patients 
      presenting with myalgia as the initial symptom of anti-neutrophil cytoplasmic 
      antibody-associated vasculitis (AAV) or polyarteritis nodosa (PAN). We included 
      93 patients diagnosed with AAV or PAN by retrospectively reviewing their clinical 
      records at the initial diagnosis. Clinical findings and diagnostic methods were 
      assessed in patients with myalgia. Of 93 patients, myalgia was observed in 21 
      (22.6%) patients, with diagnostic classifications of microscopic polyangiitis 
      (MPA) in 12 (52.4%), granulomatosis with polyangiitis in 2 (9.5%), eosinophilic 
      granulomatosis with polyangiitis in 2 (9.5%), and PAN in 5 (23.8%). Myalgia was 
      present in the lower extremities of all patients; more than 80% of patients had 
      pain in the calf muscle. In 10 patients with myalgia, including 7 with MPA and 3 
      with PAN, muscle biopsy was performed because myalgia was the main symptom and no 
      other impaired organs were suitable for biopsy. Consequently, 8 patients had 
      necrotizing vasculitis, leading to MPA or PAN diagnosis, although muscle 
      pathology was not evaluated in patients without myalgia. Muscle magnetic 
      resonance imaging was useful in determining the biopsy site. Myalgia, especially 
      in the lower limbs, may be an initial clinical sign of vasculitis, particularly 
      in MPA or PAN patients. Moreover, the histological evidence of muscular 
      vasculitis can contribute to a definite diagnosis especially in patients 
      presenting with myalgia as an early symptom of AAV or PAN.
FAU - Ushiyama, Satoru
AU  - Ushiyama S
AUID- ORCID: 0000-0003-0273-0384
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
FAU - Shimojima, Yasuhiro
AU  - Shimojima Y
AUID- ORCID: 0000-0001-7100-1121
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. yshimoji@shinshu-u.ac.jp.
FAU - Ueno, Ken-Ichi
AU  - Ueno KI
AUID- ORCID: 0000-0002-9351-3440
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
FAU - Kishida, Dai
AU  - Kishida D
AUID- ORCID: 0000-0001-8309-7984
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
FAU - Miyazaki, Daigo
AU  - Miyazaki D
AUID- ORCID: 0000-0002-0032-0077
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
FAU - Sekijima, Yoshiki
AU  - Sekijima Y
AUID- ORCID: 0000-0002-8132-2743
AD  - Department of Medicine (Neurology and Rheumatology), Shinshu University School of 
      Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
AD  - Institute for Biomedical Sciences, Shinshu University, 3-1-1 Asahi, Matsumoto, 
      390-8621, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200724
PL  - Germany
TA  - Rheumatol Int
JT  - Rheumatology international
JID - 8206885
SB  - IM
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/*diagnosis/physiopathology
MH  - Female
MH  - Humans
MH  - Lower Extremity
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Muscle, Skeletal/diagnostic imaging/pathology
MH  - Myalgia/*etiology
MH  - Polyarteritis Nodosa/*diagnosis/physiopathology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - ANCA-associated vasculitis
OT  - Microscopic polyangiitis
OT  - Myalgia
OT  - Polyarteritis nodosa
EDAT- 2020/07/28 06:00
MHDA- 2021/06/08 06:00
CRDT- 2020/07/26 06:00
PHST- 2020/04/21 00:00 [received]
PHST- 2020/07/11 00:00 [accepted]
PHST- 2020/07/28 06:00 [pubmed]
PHST- 2021/06/08 06:00 [medline]
PHST- 2020/07/26 06:00 [entrez]
AID - 10.1007/s00296-020-04652-y [pii]
AID - 10.1007/s00296-020-04652-y [doi]
PST - ppublish
SO  - Rheumatol Int. 2020 Oct;40(10):1667-1674. doi: 10.1007/s00296-020-04652-y. Epub 
      2020 Jul 24.