Long-term follow-up of cognitive dysfunction in patients with aluminum hydroxide-induced macrophagic myofasciitis (MMF)

J Inorg Biochem. 2011 Nov;105(11):1457-63. doi: 10.1016/j.jinorgbio.2011.08.006. Epub 2011 Aug 22.


Macrophagic myofasciitis (MMF) is characterized by specific muscle lesions assessing long-term persistence of aluminum hydroxide within macrophages at the site of previous immunization. Affected patients are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and cognitive dysfunction. Representative features of MMF-associated cognitive dysfunction (MACD) include (i) dysexecutive syndrome; (i) visual memory; (iii) left ear extinction at dichotic listening test. In present study we retrospectively evaluated the progression of MACD in 30 MMF patients. Most patients fulfilled criteria for non-amnestic/dysexecutive mild cognitive impairment, even if some cognitive deficits seemed unusually severe. MACD remained stable over time, although dysexecutive syndrome tended to worsen. Long-term follow-up of a subset of patients with 3 or 4 consecutive neuropsychological evaluations confirmed the stability of MACD with time, despite marked fluctuations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aluminum Hydroxide / adverse effects*
  • Brain / pathology
  • Cognitive Dysfunction / chemically induced*
  • Cognitive Dysfunction / complications
  • Cognitive Dysfunction / psychology
  • Depression / etiology
  • Fasciitis / chemically induced*
  • Fasciitis / complications
  • Fasciitis / psychology
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Myositis / chemically induced*
  • Myositis / complications
  • Myositis / psychology
  • Neuropsychological Tests
  • Retrospective Studies


  • Aluminum Hydroxide

Supplementary concepts

  • Macrophagic myofasciitis