TOXOPLASMIC POLYMYOSITIS REVISITED - CASE-REPORT AND REVIEW OF LITERATURE

Toxoplasmosis can cause polymyositis either by reactivation or by rece nt infection. inconsistent response to antiprotozoal therapy has been the strongest argument against toxoplasmic polymyositis as a separate entity. We report a biopsy-proven case of toxoplasmic polymyositis in a cardiac transplant patient presenting with a severe proximal weaknes s, myopathic, electromyographic changes and ten-fold increase of anti- Toxoplasma antibodies, An early antiprotozoal therapy and plasmapheres is led to recovery. A review of previously reported cases of toxoplasm ic polymyositis suggests that an early antiprotozoal therapy is the mo st important variable affecting the outcome of this disease. We propos e that toxoplasmic polymyositis has two phases: acute, responsive to a ntiprotozoal therapy, and chronic, manifested by altered immune respon se requiring steroids. We suggest that all patients presenting with po lymyositis should have serological tests for toxoplasmosis as a part o f their initial evaluation and an early trial of antiprotozoal therapy in case of positive findings. (C) 1997 Elsevier Science B.V.