Acute febrile myopathy in intravenous drug users: clinical and morphological study
Fernández-Solá, J.; Grau, J.M.; Estruch, R.; Pedro-Botet, J.C.; Casademont, J.; Urbano-Márquez, A.
Medicina Clinica 91(4): 128-130
1988
ISSN/ISBN: 0025-7753 PMID: 3172915 Document Number: 308513
A series of 9 parenteral drug abusers (PDA) (heroin) with acute febrile myopathy(AFM) is reported. The cases were collected during one year in a service of general Internal Medicine. Their clinical presentation is described with paravertebral myalgia predominating in 6 patients. Muscular enzymes (creatine phosphokinase, aldolase) were increased in 6 cases. Microbiological studies were negative. In the muscular histology fibre necrosis and subsarcolemmal deposits were apparent in 6 out 7 patients with biopsy. Occasionally, hypercontracted fibres, splitting, internal nuclei, and moth-eaten fibres were found. There were ultrastructural abnormalities in all cases where endomysial fibrosis and mitochondrial anomalies predominated. A control group of 9 PDA without AFM did not show these abnormalities. The presence of antibodies against the human immunodeficiency virus in one patient with AFM and in 2 patients from the control group did not modify the morphological pattern.