Inflammatory myopathies after allogeneic stem cell transplantation

Muscle Nerve. 2018 Dec;58(6):790-795. doi: 10.1002/mus.26341. Epub 2018 Nov 20.

Abstract

Introduction,: Graft-versus-host disease (GVHD) is a recognized complication of allogeneic stem cell transplantation (allo-SCT) and may affect muscle. We investigated the incidence and subtypes of inflammatory myopathy (IM) in South Australian recipients of allo-SCT.

Methods: Recipients of allo-SCT from 2004 to 2014 at the Royal Adelaide Hospital were identified. Records were reviewed to identify patients with weakness, creatine kinase (CK) elevation, and muscle biopsy confirming IM.

Results: Weakness was present in 32 of 224 patients who received allo-SCT patients reviewed, and CK was raised in 7 of 20 patients with weakness. Six patients developed biopsy-confirmed IM; 3 patients had chronic GVHD-related myopathy, 2 had necrotizing myopathy, and 1 had dermatomyositis (DM) associated with anti-melanoma differentiation associated protein 5 (MDA5) antibodies. The incidence of IM was calculated to be 2 cases per thousand annually.

Discussion: Among recipients of allo-SCT, weakness is common, and the incidence of IM is increased. Histopathological diagnoses are varied, and we report findings of necrotizing myopathy and anti-MDA5-associated DM. Muscle Nerve 58:790-795, 2018.

Keywords: graft-versus-host disease; inflammatory myopathy; myositis; stem cell transplant; weakness.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allografts / metabolism
  • Antigens, CD / metabolism
  • Australia
  • Creatine Kinase / blood
  • Electromyography
  • Female
  • Graft vs Host Disease / etiology*
  • Histocompatibility Antigens / metabolism
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Myositis / epidemiology
  • Myositis / etiology*
  • Postoperative Complications / etiology*
  • Prevalence
  • Retrospective Studies
  • Stem Cell Transplantation / adverse effects*
  • Young Adult

Substances

  • Antigens, CD
  • Histocompatibility Antigens
  • Creatine Kinase