Presentation
It is frequently present at the onset of disease and it may even precede muscular manifestations of IIM. [ncbi.nlm.nih.gov]
Gastrointestinal
-
Dysphagia
Four to six weeks after IVMP, dysphagia had resolved in 2 and improved in 3. [ncbi.nlm.nih.gov]
He also reported dysphagia to solids over the past week. The patient was recently admitted twice to an outside hospital for an elevated creatine phosphokinase, and diagnosed with “rhabdomyolysis.” [f1000research.com]
Pharyngeal weakness causes dysphagia. Weakness may vary from week to week or month to month. Only a third have pain. There is no rash. [patient.info]
Musculoskeletal
-
Muscle Weakness
BACKGROUND: The purpose of this case series was to quantify different strategies used to compensate in gait for hip muscle weakness. [ncbi.nlm.nih.gov]
Inclusion body myositis causes severe muscle weakness. Loss of coordination is experienced as the muscles are damaged. Small holes appear in the fiber of the muscles. [myphiladelphiadisabilitylawyer.com]
Discussion Myasthenia, or simply muscle weakness, is a common admitting diagnosis in the inpatient setting with a broad differential. [f1000research.com]
-
Osteopenia
Osteoporosis and osteopenia were the most common concomitant diseases observed, at 111 per 1,000 patient years, followed by lung involvement with 78 events per 1,000 patient years follow-up. [ncbi.nlm.nih.gov]
The cumulative steroid dose data was not known and would have been useful given the high concomitant incidence of osteoporosis/osteopenia in this cohort. [nzma.org.nz]
-
Joint Tenderness
History of arthritis, 68-joint and 66-joint tender and swollen joint index, clinical features of IIM, and autoantibody profiles were obtained by clinical examination, personal interview, and review of patient records. [ncbi.nlm.nih.gov]
-
Muscular Atrophy
Muscular atrophy occurs with preservation of tendon reflexes, flexor plantar response and normal sensation. Muscles may be tender on palpation and may have a nodular grainy feel. Investigations Creatine kinase can be up to 50 times normal. [patient.info]
Workup
Bauer said the Swedish study is unlikely to alter U.S. practice and in fact supports the current approach, which involves a thorough malignancy and pulmonary workup at time of diagnosis. [medpagetoday.com]
We recommend that a muscle biopsy is performed in the workup of a patient suspected of having IIM whenever possible as there are reported cases of non-inflammatory myopathies that can mimic IIM. 19 One factor contributing to the low rate of muscle biopsy [nzma.org.nz]
NAM has been associated with malignancy and statin use. [6] See Etiology, Presentation, and Workup. Polymyositis and dermatomyositis have many shared clinical features. Both present as symmetrical muscle weakness that develops over weeks to months. [emedicine.medscape.com]
Microbiology
-
Candida
(seven cases) [ 146 – 148 ], pneumonia secondary to Candida albicans (one case) [ 145 ], Aspergillus fumigatus (three cases) [ 17, 149, 150 ], Aspergillus niger (one case) [ 150 ], lung abscess due to Cryptococcus laurentii (one case) [ 151 ], blastomycosis [err.ersjournals.com]
Treatment
Patients with inflammatory myositis of recent onset who had not received treatment were evaluated for associated myocarditis by magnetic resonance imaging (MRI) and reinvestigated after treatment with high dose corticosteroids and immunosuppressors. [ncbi.nlm.nih.gov]
Prognosis
SUMMARY: Myositis-specific autoantibodies are useful markers for clinical diagnosis, classification and predicting prognosis of idiopathic inflammatory myopathy. [ncbi.nlm.nih.gov]
Etiology
DRB1*0301 was a common genetic risk factor for familial and sporadic IIM, but contributed less to the genetic risk of familial IIM (etiologic fraction 0.35 versus 0.51 in sporadic IIM). [ncbi.nlm.nih.gov]
Epidemiology
Author information 1 Department of Epidemiology, Flinders University, Adelaide, South Australia, Australia. 2 Clinical Epidemiology Unit, Flinders Medical Centre, Adelaide, South Australia, Australia. 3 Rheumatology Department, Royal Adelaide Hospital [ncbi.nlm.nih.gov]
Clinical and epidemiological research Mortality in idiopathic inflammatory myopathy: results from a Swedish nationwide population-based cohort study Gerd Cecilie Dobloug 1, John Svensson 2, Ingrid E Lundberg 2, Marie Holmqvist 2, 3 1 Department of Rheumatology [ard.bmj.com]
Moghadam-Kia, Siamak (2015) Epidemiology of idiopathic inflammatory myopathies and statin myopathy. Master Essay, University of Pittsburgh. Abstract Myopathies are generally divided into acquired and inherited forms. [d-scholarship.pitt.edu]
However, several epidemiologic features make this a particularly difficult diagnosis in this patient. Foremost, polymyositis is a rare disease with incidence rates occurring in about 1 per 100,000 people annually 4 – 7. [f1000research.com]
Pathophysiology
This review examines recent progress in myositis-specific autoantibodies, particularly in their clinical significance and pathophysiological roles. [ncbi.nlm.nih.gov]
[…] cytoxic mechanisms in polymyositis, to a complement-mediated vasculopathy of the small vessels in muscle tissues in dermatomyositis, to a primarily macrophage driven degeneration in immune-mediated necrotizing myopathy have all been ascribed as the pathophysiology [f1000research.com]
However, in the recent years, several new studies were published allowing us to better understand the clinical characteristics and pathophysiology of cancer-associated IIMs. [najms.org]
Further studies are needed to better understand the pathophysiology of ILD related to dermatomyositis/polymyositis, and to investigate the effectiveness and tolerance of targeted therapies in randomised controlled trials. [err.ersjournals.com]
Prevention
Exercise training could be one way to prevent or delay the negative effects of the disease and the impairments seen in patients with an IIM. The objective was to examine whether exercise training is safe and effective in patients with an IIM. [ncbi.nlm.nih.gov]
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
Because patients taking prednisone are at risk for osteoporosis, they should receive proper treatment to prevent it. [rheumatology.org]
Biologicals' Influenza Vaccine in Children Completed NCT01218308 Phase 3 27 Efficacy and Safety Study of GB-0998 for Treatment of Steroid-resistant Polymyositis and Dermatomyositis (PM/DM) Completed NCT00335985 Phase 3 GB-0998;Placebo of GB-0998 28 Prevention [malacards.org]