Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?: A case report. Issue 39 (September 2017)

• Record Type: Journal Article
• Authors: Van Der Gucht, Axel; Abulizi, Mukedaisi; Blanc-Durand, Paul; Aoun-Sebaiti, Mehdi; Emsen, Berivan; Gherardi, Romain K.; Verger, Antoine; Authier, François-Jérôme; Itti, Emmanuel
• Other Names: Rosca. Elena Cecilia section editor.
• Is Part Of: Medicine. Volume 96:Issue 39(2017)
• Publication Date: 2017-09
• Subjects: aluminum hydroxide -- brain imaging -- 18F-FDG -- macrophagic myofasciitis -- PET/CT; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008134
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Although several functional studies have demonstrated that positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging technique for MMF remains unclear. Patient concerns: We presented data and images of a 46-year-old woman. Diagnoses: The patient was referred to our center for suspected MMF due to diffuse arthromyalgias and cognitive disorder (involving an impairment of visual selective attention and a weakness in executive functions revealed by neuropsychological assessment) which occurred few years after last vaccine injections. Interventions: After a first negative deltoid muscle biopsy, a brain 18 F-FDG PET/CT was performed and revealed the known spatial pattern of a cerebral glucose hypometabolism involving occipital cortex, medial temporal areas, and cerebellum. Outcomes: Given the clinical suspicion of MMF and brain 18 F-FDG PET/CT findings, a 2nd deltoid muscle biopsy was performed and confirmed the diagnosis of MMF with typical histopathological features. Lessons: This case highlights the predictive value of brain 18 F-FDG PET/CT as a noninvasive imaging tool for MMF diagnosis, even when muscle biopsy result comes back negative.