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A further patient with parasitic myositis due to Haycocknema perplexum, a rare entity


McKelvie, P and Reardon, K and Bond, K and Spratt, DM and Gangell, A and Zochling, J and Daffy, J, A further patient with parasitic myositis due to Haycocknema perplexum, a rare entity, Journal of Clinical Neuroscience, 20, (7) pp. 1019-1022. ISSN 0967-5868 (2013) [Contribution to Refereed Journal]

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DOI: doi:10.1016/j.jocn.2012.08.009


A new genus of nematode, Haycocknema perplexum, causing polymyositis in humans, was first described in two Australian patients from Tasmania in 1998. Three patients with myositis due to the same nematode were reported from northern Queensland in 2008. We report the sixth case from Australia, a 50-year-old man, also from Tasmania. He had a 2-year history of progressive weakness, weight loss of 10 kg and dysphagia. Muscle biopsy was initially interpreted as polymyositis with eosinophils. Maximum creatine kinase (CK) level was 5700 U/L and full blood examination was normal. He deteriorated after several months of treatment with prednisolone and methotrexate and review of the muscle biopsy showed intramyofibre parasites of H. perplexum. After 3 months of treatment with albendazole therapy, he made a very good clinical recovery and his CK decreased to 470 U/L. This uniquely Australian parasite can mimic polymyositis and leads to significant irreversible morbidity (two of the previous patients still have weakness and elevated CK after years) and even mortality (one died), if diagnosed late or after corticosteroids. Diagnosis can only be made by histopathology of muscle biopsy. © 2012 Elsevier Ltd. All rights reserved.

Item Details

Item Type:Contribution to Refereed Journal
Keywords:Dysphagia, Haycocknema perplexum, Parasitic myositis, Severe muscle weakness
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Zochling, J (Dr Jane Zochling)
ID Code:86093
Year Published:2013
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2013-08-22
Last Modified:2013-08-22

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