Inflammatory Muscle Diseases

To the Editor: In the review article on inflammatory muscle diseases, Dalakas (April 30 issue) 1 outlines four major subtypes. In 1998, Gherardi et al. described a new but underrecognized clinical variant, called macrophagic myofasciitis, 2 a condition that presents as diffuse myalgias of variable intensity associated with chronic fatigue. Myalgia predominantly affects the lower limbs and is often aggravated by exercise. It is associated with arthralgias in 50 to 60% of patients, as well as fever in 30% of patients. 3 Results on electromyography may be myopathic, and creatine kinase levels may be elevated in up to 50% of patients. 4 This disease . . .