Polymyositis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate polymyositis (inflammatory disease of the muscles): Main symptoms Symmetrical muscle weakness (especially of proximal extremity muscles/upper arms and thighs, or shoulder/pelvic girdle). Muscle soreness myalgias (muscle pain). Sclerosis (hardening) and atrophy of shoulder/upper arm and pelvic/thigh muscles. Affected individuals are unable to raise their arms above their head … Polymyositis: Symptoms, Complaints, Signs

Polymyositis: Causes

Pathogenesis (disease development) The exact causes of polymyositis have not yet been determined. What has been proven so far are genetic factors (HLA associations) and pathologic autoimmunologic processes, meaning that the body’s immune system attacks myocytes (muscle cells). In contrast to dermatomyositis, in which antibodies cause myositis (muscle inflammation) by damaging the small blood vessels, … Polymyositis: Causes

Polymyositis: Therapy

General measures In the acute phase of the disease: bed rest or physical rest. Review of permanent medication due topossible effect on the existing disease. Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among … Polymyositis: Therapy

Polymyositis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of polymyositis (inflammatory disease of the musculature). Family history Is there a family history of muscle disease, autoimmune disease? Are there any hereditary diseases in your family? Social history What is your profession? Is there any evidence of psychosocial stress or strain due … Polymyositis: Medical History

Polymyositis: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Hypothyroidism (underactive thyroid gland); rare. Musculoskeletal system and connective tissue (M00-M99). Inclusion body myositis – neuromuscular disease; weakness near the trunk, fewer atrophies. Muscular dystrophies (muscle atrophy). Myositides (muscle inflammation), infectious origin (Coxsackie viruses, trichinosis, HIV). Polymyalgia rheumatica – inflammatory rheumatic disease belonging to the vasculitides (vascular inflammation); pain … Polymyositis: Or something else? Differential Diagnosis

Polymyositis: Symptoms, Causes, Treatment

Polymyositis (PM) (synonyms: acute parenchymal myositis; genuine polymyositis; hemorrhagic polymyositis; idiopathic inflammatory polymyositis; idiopathic polymyositis; myositis universalis acuta infectiosa; polymyositis in collagenoses (overlap-group/overlap syndromes); polymyositis with pulmonary involvement); ICD-10 M33. 2: polymyositis) is an inflammatory systemic disease of skeletal muscle (poly: much; myositis: muscle inflammation; thus, inflammation of many muscles) with lymphocytic infiltration (invasion of … Polymyositis: Symptoms, Causes, Treatment

Polymyositis: Complications

The following are the most important diseases or complications that may be contributed to by polymyositis (inflammatory disease of the muscles): Respiratory system (J00-J99) Aspiration pneumonia (pneumonia caused by inhalation of foreign substances (often stomach contents)) – due to weakness of the esophageal muscles (muscles of the esophagus). Pulmonary fibrosis (connective tissue remodeling of the … Polymyositis: Complications

Polymyositis: Classification

Polymyositis (inflammatory disease of the muscles) is classified as follows: Form Frequency Primary idiopathic (without identifiable cause) polymyositis 34 % Primary idiopathic dermatomyositis* 29 % Polymyositis/dermatomyositis associated with malignant tumors (concomitant disease of cancer) 9% Polymyositis/dermatomyositis with vasculitis (inflammation of blood vessels) in childhood 7 % Polymyositis/dermatomyositis in collagenoses (overlap-group/overlap syndromes). 21 % * Dermatomyositis … Polymyositis: Classification

Polymyositis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Gait pattern (fluid, limping) Body or joint posture (upright, bent, relieving posture). Extremity muscles/upper arms and thighs or shoulder/pelvic girdle. Auscultation (listening) of the heart [because … Polymyositis: Examination

Polymyositis: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Small blood count, differential blood count [leukocytosis with left shift (may occur)] Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Muscle enzymes Creatine kinase (CK) [↑] Aldolase [↑] GOT [↑] Lactate dehydrogenase (LDH) [↑] Possibly detection of myoglobin in serum and urine. Immunological parameters … Polymyositis: Test and Diagnosis

Polymyositis: Drug Therapy

Therapeutic targets Symptom relief Immunosuppression Therapy recommendations Systemic treatment Central treatment with glucocorticoids: Prednisolone; possibly higher initial dose in the first 4 weeks. Cave: fluorinated glucocorticoids such as dexamethasone and triamcinolone can cause myopathies (muscle pain) and should be avoided! Due to long-term treatment, if necessary, substitution of calcium and vitamin D. In case of … Polymyositis: Drug Therapy

Polymyositis: Diagnostic Tests

Obligatory medical device diagnostics. Electromyography (EMG; measurement of muscle electrical activity)/nerve conduction velocity – to detect a change in electrical activity in the muscle. Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well suited for imaging soft tissue injuries) – to find the right sampling site for biopsy, … Polymyositis: Diagnostic Tests