Polymyositis
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| Polymyositis Classification and external resources | |
| ICD-10 | M33.2 |
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| ICD-9 | 710.4 |
| DiseasesDB | 10343 |
| MedlinePlus | 000428 |
| eMedicine | med/3441 emerg/474 |
| MeSH | D017285 |
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Overview
Polymyositis is a type of inflammatory myopathy, related to dermatomyositis and inclusion body myositis. Polymyositis means 'many muscle inflammation'.
Polymyositis tends to become evident in adulthood, presenting with bilateral proximal muscle weakness, often noted in the upper legs due to early fatigue while walking. Sometimes the weakness presents itself by the person being unable to rise from a seated position without help, or inability to raise their arms above their head. The weakness is generally progressive, accompanied by lymphocytic inflammation (mainly cytotoxic T8 lymphocytes). The cause is unknown, but seems to be related to autoimmune factors, genetics, and perhaps viruses. In rare cases, the cause is known to be infectious, associated with the pathogens that cause Lyme disease, toxoplasmosis, and others.[1]
Polymyositis, like dermatomyositis, strikes females with greater frequency than males. The skin involvement of dermatomyositis is absent in polymyositis.
Diagnosis
Diagnosis is fourfold, including elevation of creatine kinase, signs and symptoms, electromyograph (EMG) alteration, and a positive muscle biopsy. Treatment generally involves glucocorticoids, especially prednisone. At present, a number of studies are underway to determine whether patients diagnosed with polymyositis will benefit from newer drugs inhibiting the biologic effects of TNF alpha, such as Infliximab ("Remicade").
Sporadic inclusion body myositis (sIBM): IBM is often confused with (misdiagnosed as) polymyositis and polymyositis that does not respond to treatment is likely IBM. sIBM comes on over months to years, polymyositis comes on over weeks to months. It appears that sIBM and polymyositis share some common features, especially the initial sequence of immune system activation, however, polymyositis does not display the subsequent muscle degeneration and protein abnormalities as seen in IBM. As well, polymyositis tends to respond well to treatments, IBM does not. IBM and polymyositis apparently involve different disease mechanisms than are seen in dermatomyositis.
References
ku:Polîmiyozît he:פולימיוזיטיסfi:Polymyosiitti
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
