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Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?

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. Abbreviations: 18 F-FDG = 18 F-fluorodeoxyglucose, MMF = macrophagic myofasciitis, PET/CT = positron emission tomography/ computed tomography.
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Submitted on : Wednesday, June 23, 2021 - 8:43:22 AM
Last modification on : Sunday, June 26, 2022 - 2:20:46 AM
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Axel van Der Gucht, Mukedaisi Abulizi, Paul Blanc-Durand, Mehdi Aoun-Sebaiti, Berivan Emsen, et al.. Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?. Medicine, Lippincott, Williams & Wilkins, 2017, 96 (39), pp.e8134. ⟨10.1097/MD.0000000000008134⟩. ⟨hal-03268262⟩



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