{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:05:32Z","timestamp":1761609932623,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,23]]},"abstract":"<jats:p>A 25-year-old man admitted for generalised muscle pain with an insidious onset 3\u2009years ago. He had exercise intolerance and decrease in muscle strength, requiring gait support. He was previously healthy, with no chronic medication or recent history of drugs or toxics. National vaccination plan actualised with hepatitis B and tetanus vaccines administered 10 and 2\u2009years, respectively, before symptom onset. No analytical, imaging or electromyography changes were found. Muscle biopsy revealed an inflammatory infiltrate predominantly macrophagic with aluminium deposits suggestive of macrophagic myofasciitis (MMF). It is probably associated with vaccines previously administered. MMF lesion can be regarded as pathological only if detected at least 18\u2009months after last aluminic immunisation, as our case illustrates.<\/jats:p>","DOI":"10.1136\/bcr-2018-224602","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T02:35:26Z","timestamp":1530671726000},"page":"bcr-2018-224602","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Macrophagic myofasciitis: a challenging diagnosis"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5822-2640","authenticated-orcid":false,"given":"Daniela","family":"Soares Santos","sequence":"first","affiliation":[{"name":"Internal Medicine, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ars\u00e9nio","family":"Santos","sequence":"additional","affiliation":[{"name":"Internal Medicine, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olinda","family":"Rebelo","sequence":"additional","affiliation":[{"name":"Neuropathology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui M","family":"Santos","sequence":"additional","affiliation":[{"name":"Internal Medicine, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,3]]},"reference":[{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311429557"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2013.10.004"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.3","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00296-014-3065-4","article-title":"Macrophagic myofasciitis and vaccination: Consequence or coincidence?","volume":"35","author":"Santiago","year":"2015","journal-title":"Rheumatol Int"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.4","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-010-8212-4"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.5","doi-asserted-by":"crossref","first-page":"230","DOI":"10.3389\/fneur.2014.00230","article-title":"Clinical features in patients with long-lasting macrophagic myofasciitis","volume":"5","author":"Rigolet","year":"2014","journal-title":"Front Neurol"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s13139-015-0371-z","article-title":"FDG-PET\/CT brain findings in a patient with macrophagic myofasciitis","volume":"50","author":"Van Der Gucht","year":"2016","journal-title":"Nucl Med Mol Imaging"},{"key":"2025082703575683000_2018.jul03_1.bcr-2018-224602.7","doi-asserted-by":"crossref","unstructured":"Aoun Sebaiti M , Kauv P , Charles-Nelson A , et al . 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