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Related Experiment Video

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Detection of Anti-MDA5 Autoantibodies Using HeLa Cells and Immunocytochemistry with Light Microscopy

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Published on: October 31, 2025

Recurrent Bilateral Focal Myositis.

Hiroko Nagafuchi¹, Hiromasa Nakano, Seido Ooka

¹Division of Rheumatology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.

Internal Medicine (Tokyo, Japan)

|November 18, 2016

Summary

This case report details a rare instance of recurrent focal myositis successfully treated with methotrexate. Methotrexate enabled steroid withdrawal, preventing disease relapse in a patient with bilateral lower limb muscle lesions.

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Area of Science:

Rheumatology
Neurology
Immunology

Background:

Focal myositis is an uncommon inflammatory muscle disease.
Recurrent or bilateral presentations are particularly rare.
Understanding treatment responses is crucial for patient management.

Observation:

A 38-year-old male presented with recurrent bilateral focal myositis.
Initial symptoms included right gastrocnemius myalgia.
Magnetic resonance imaging revealed significant muscle signal abnormalities.

Findings:

Muscle biopsy confirmed CD4+ cell-dominant inflammatory myogenic changes.
Steroid therapy provided initial relief but relapses occurred upon dose reduction.
Methotrexate treatment facilitated successful steroid tapering and achieved sustained remission for 4 years.

Implications:

Methotrexate represents a viable therapeutic option for refractory or recurrent focal myositis.
This case highlights the potential for steroid-sparing agents in managing complex myositis cases.
Further research into optimal treatment strategies for focal myositis is warranted.