Polymyositis is a clinical picture that is not too common. According to statistical surveys, about 80 out of 100,000 people suffer from this disease. Of the women, about twice or three times as many patients are affected than this is the case in men.
What is polymyositis?
To define polymyositis, it is beneficial to look at the individual components of the term. Under the part of speech poly- the term is understood many, many times. The part myo- names the muscle. The Greek ending -itis always indicates an inflammatory process. Thus, polymyositis is an inflammation that affects various muscles of the body. In medicine, polymyositis is categorized as a so-called collagenosis. In this context, polymyositis belongs to the rheumatic diseases, which are characterized by a chronic course. In polymyositis, the muscle fibers and connective tissue are primarily affected by inflammatory impairments. Polymyositis progresses in episodes in most affected individuals, so that acute signs of the disease may also occur.
Causes
In finding the causative triggers for polymyositis, it has not yet been possible to determine them unequivocally. It is assumed that polymositis, as an autoimmune disease, is promoted by a destruction of muscle cells by the body’s immune defense system. Basically, hereditary causes are not among the factors leading to polymyositis. In polymyositis, specific viruses or pre-existing diseases from the chronic rheumatic or collagenous circle can also be considered as a cause.
Symptoms, complaints, and signs
Polymyositis is initially manifested by rather nonspecific symptoms. Affected individuals initially feel tired and fatigued and are less able to perform overall. The inflammatory disease eventually also causes fever and chills. In parallel, sweating, high blood pressure and loss of appetite occur, each associated with further complaints and complications. General symptoms such as irritability and malaise occur more frequently and increase in intensity in the course of the first weeks of the disease. Another characteristic of polymyositis is soreness in the affected muscles. These complaints occur mainly in the arms and legs and independently of physical exertion. However, pain or tension also sets in during movement. If the neck muscles are involved, movement disorders may also occur in the area of the head. The chronic form of muscle inflammation occasionally progresses without noticeable muscle pain. Only in the later stages can the disease be diagnosed on the basis of clear signs of illness. If the lungs or larynx are involved, the patient experiences shortness of breath, difficulty swallowing and the typical lump in the throat. The pathogens can spread to surrounding regions and, in the worst case, even to the heart. This is accompanied by muscle wasting and weight loss. If left untreated, the muscle inflammation can lead to organ failure and thus to the death of the patient.
Diagnosis and course
The clinical course of polymyositis is characterized by the appearance of painful abnormalities that are similar to muscle soreness. Patients suffering from polymyositis also show symptoms such as fatigue and lack of strength, a decrease in muscle mass, and usually a so-called dermatomyositis. As a classic concomitant disease of polymyositis, dermatomyositis is usually accompanied by water retention in the skin, erythema (dark red to purple discoloration of the skin), papules and skin erosions. In an acute course, polymyositis can lead to a loss of function of the lung muscles, shock and even a lethal outcome. Clearly elevated values are found in polymyositis in the determination of creatine kinase, an enzyme that is required for the breakdown of muscle protein. In the diagnosis of polymyositis, it is important to aim for laboratory values with regard to the determination of endogenous antibodies, quantitative testing of the so-called muscle enzymes and special muscle proteins. In addition, in the differential diagnosis of polymyositis, it is important to accurately record the patient’s symptoms and perform a visual assessment.Among the central indications, which are of enormous relevance in the diagnosis of polymyositis, are the Raynaud’s phenomena, which occur primarily in the hands. Electromyography is recommended as another diagnostic procedure in polymyositis.
Complications
Polymyositis is characterized by a number of different complaints in the patient. As a rule, those affected thereby suffer from permanent muscle soreness and also muscle weakness. As a result, strenuous physical activities and even certain types of sports are no longer possible for the affected person without further ado. Fever and joint pain are also not uncommon and continue to reduce the quality of life of the affected person enormously. Patients may also suffer from swallowing difficulties, so that the intake of food may be disturbed. This can lead to weight loss or various deficiency symptoms. The skin can also be affected by this disease, so that patients suffer from redness or scaly skin. In some cases, this can lead to inferiority complexes or depression and other psychological upsets. As a rule, patients also feel ashamed of these complaints. Polymyositis is treated with the help of medication. As a rule, there are no further complications or other complaints. In most cases, however, patients are dependent on prolonged therapy. The life expectancy of those affected is usually not affected by this disease.
When should you see a doctor?
If, over a period of several weeks or months, general performance steadily decreases, a follow-up visit to a physician should be made. Fatigue, increased tiredness or a loss of vital energy are warning signs of the organism and should be clarified. In case of inflammatory processes, sweating or a decrease of the usual resilience, a visit to the doctor is necessary. Disturbances of the heart rhythm, high blood pressure as well as flu-like symptoms such as chills or fever should be presented to a physician. Shortness of breath, interruptions in the act of swallowing or impaired muscle strength are signs of a health disorder. If the irregularities persist or increase in intensity, a doctor’s visit is recommended. Tension in the neck, internal irritability, a diffuse feeling of illness, and general malaise should be examined and treated. If muscle atrophy is observed, a physician should be consulted immediately. If there is a loss of dead weight, dysfunction, and pain, action is required. Since polymyositis can lead to premature death of the affected person if left untreated, a visit to the doctor should be made at the first irregularities or abnormalities. If acute respiratory distress or loss of consciousness occurs, emergency medical services are required. In parallel, first aid techniques should be performed by those present to ensure the survival of the victim until the arrival of the emergency physician.
Treatment and therapy
As part of the therapy of polymyositis, physicians and patients rely on the use of particularly high-quality drugs. In this regard, the focus of drug treatment is on high doses of steroidal drugs, which are prescribed to inhibit inflammatory episodes. In combination with these steroidal anti-inflammatory drugs, such as prednisone, the drugs known as immunosuppressants are also taken to treat polymyositis. If the affected person does not respond to these drugs and the degeneration of the muscles continues, the infusion-based administration of immunoglobulins (special protein bodies) has proven effective. This also helps to reduce the other doses of medication. This is especially beneficial considering the very unpleasant side effects of prednisone in polmyositis.
Prevention
There is no effective prophylaxis against polymyositis. Because an autoimmune disease, such as polymyositis is, originates from factors that are not yet precisely recognized in the body, there is no way to influence these processes. The effectiveness of targeted protection against common pathogenic microorganisms such as bacteria, viruses or parasites cannot be proven with regard to the development of polymyositis.For this reason, it is not possible to initiate meaningful preventive measures against polymyositis.
Follow-up
Inflammation of skeletal muscles is always associated with pain sensation. The internal organs may also be affected. Polymyositis heals completely with proper therapy. In severe courses, it can have a fatal outcome. The inflammatory process favors immune diseases, malignant tumors and arthritis. Because of these risks, follow-up care must be provided. The symptoms are similar to those of muscle atrophy (dystrophy). A differential diagnosis provides information about the actual cause. Therapy against polymyositis is very complex. On average, the treatment period is five years. The inflammation is treated immunosuppressively. The specialist monitors the patient’s condition, as the drugs are associated with strong side effects. Painkillers relieve the symptoms and contribute to the quality of life of the affected person. Even after treatment is completed, many patients suffer from muscle weakness. It cannot be reversed, and preventive measures against further damage are useful. Physiotherapeutic exercises are recommended as aftercare. They must be performed regularly to ensure long-term success. Mobility is maintained and further muscle damage is prevented. At the specialist’s office, the patient is instructed on how to deal appropriately with the muscle weakness. In case of rapid deterioration, treatment must be resumed immediately.
What you can do yourself
In the case of polymyositis, medical treatment must first take place. Depending on how severe the inflammation is, the patient can take various measures to support the therapy. A change in diet is important. Polymyositis patients should not consume foods that promote inflammation, for example spicy foods, coffee or alcohol. In addition, they should drink enough water and supplement their diet with nutritional supplements if necessary. Patients are best advised to talk to a nutritionist about a suitable diet. In addition, rest is important, because the muscles are usually very sensitive to pain and weakened. Special pressure bandages and compresses with soothing medicines can reduce the pain. If the symptoms become more severe, it is best to inform the doctor. During treatment, it is important to monitor the symptoms and watch out for any side effects or interactions of the treatment. In case of doubt, the responsible physician should be consulted. However, polymyositis can be treated well, provided it is detected at an early stage. Therefore, an important self-help measure is to recognize inflammation and have it examined. Sports and a conscious lifestyle help to detect possible diseases at an early stage.
