Macrophagic myofasciitis
| Macrophagic myofasciitis | |
|---|---|
| Other names | MMF |
| Specialty | Histopathology |
A macrophagic myofasciitis (MMF) lesion a histopathological finding involving inflammatory microphage formations with aluminium-containing crystal inclusions and associated microscopic muscle necrosis in biopsy samples of the injection site. A MMF "syndrome" refers to a muscle pain or weakness that, when biopsied, often results in the observation of a MMF lesion.
It is dubious whether the systemic "syndrome" represents a biological process connected to the local lesion, or even whether it is a specific condition.[1] Most cases are reported in France, where there are more than 600 diagnoses among an immunized population of more than 64 million.[1] The World Health Organization has concluded that
There is no evidence to suggest that MMF is a specific illness. MMF is a lesion containing aluminium salts, identified by histopathological examination, found at the site of previous vaccination with an aluminium-containing vaccine.[2][3]
The syndrome
MMF was originally described as a syndrome, with myalgia, arthralgia, marked asthenia, muscle weakness and fever as symptoms. Patients tend to have elevated creatine kinase, erythrocyte sedimentation rate, and a myopathic electromyograph.[1]
The lesion
People with MMF-the-syndrome generally have a muscle biopsy consistent with MMF-the-lesion. Seen within the muscle are sheets of macrophage infiltration that stain positive with periodic acid–Schiff stain. Aluminum has been detected in these samples by energy-dispersive X-ray spectroscopy.[1] The individuals had a history of receiving aluminium-containing vaccines, administered months to several years prior to observation of MMF lesion.[2][3]
A hypothetical interpretation of the biopsy finding is that the macrophages are stuck in a "death loop": MP ingests the aluminum, the aluminum causes lysosome rupture, the MP dies, and a newly arrived MP ingests the dead MP (along with the aluminum within) to repeat the loop.[1]
References
- 1 2 3 4 5 Petrovsky N (November 2015). "Comparative Safety of Vaccine Adjuvants: A Summary of Current Evidence and Future Needs". Drug Safety. 38 (11): 1059–1074. doi:10.1007/s40264-015-0350-4. PMC 4615573. PMID 26446142.
- 1 2 "WHO | Macrophagic myofasciitis and aluminium-containing vaccines". WHO. Archived from the original on February 10, 2015. Retrieved 2019-08-14.
- 1 2 "WHO | Questions and Answers about macrophagic myofasciitis (MMF)". WHO. Archived from the original on July 13, 2014. Retrieved 2019-08-16.