engleski

MASTICATORY MUSCLE MYOSITIS (MMM) IN MALTESE

Masticatory muscle myositis is an inflammatory myopathy in which patients most commonly present with jaw pain or inability to open the jaw (trismus), jaw pain, and swelling or atrophy of the muscles of mastication with subsequently lower food intake and weight loss. The average age of onset for masticatory muscle myositis is 3 years of age. It is an autoimmune process in which circulating antibodies specifically target the masticatory muscles. Mainly affected are large breed dogs. It can be acute or, more commonly, chronic phase of the disease. Complete physical and neurologic examinations are important to confirm that clinical signs are restricted to the muscles of mastication. Dogs generally demonstrate no other neurologic or physical abnormalities, which may help differentiate it from other causes of trismus. Masticatory muscle myositis requires early detection and aggressive immunosuppressive therapy to improve the prognosis. jaw pain, and swelling or atrophy of the muscles of mastication. The average age of onset for masticatory muscle myositis is 3 years of age. Clinical findings: A 9 year-old nutered male maltese was presented for evaluation of a 4 months history of inability to open the mouth. Trias was within normal ranges, palpable lymph nodes of physiological size, painless jaw. Trigeminal nerve paralysis and central neurological lesions were excluded after neurological examination. Laboratory findings reveal slightly increased eosinophyls, serum globulins and creatinine kinase (CK). Radiograph of bilateral temporomandibular joint (TMJ) excluded ankylosis, osteoarthritis, luxation, and also jaw fracture or neoplasia. Basic diagnostic tool is radiography and enzyme-linked immunosorbent assay wich is highly specific (100%) and sensitive (85% to 90%). Biopsy, MRI and CT imaging are useful but require general anaesthesia. With biopsy of masticatory musle submitted for histopathology examination lymphocitic-plasmocytic cellular infiltrats, muscle atrophy and in the end stage fibrosis could be found The only treatment is immunosupresive dose of corticosteroids. It is essential that patients be treated aggressively with less likely remission in the future. Patients treated in the chronic phase of the disease carry a more uncertain prognosis. Extensive fibrosis result in persistent jaw dysfunction. Secondary complications could be cahexia and lingual venous congestion which could be life threatening and also exophtalmos and strabismus.

Masticatory muscle ; Myositis ; Diagnostic ; Treatment ; Maltese

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