Interní Med. 2005; 7(11): 480-483

Differential diagnosis and treatment of idiopathic inflammatory myopathies

prof. MUDr. Jiří Vencovský DrSc
Revmatologický ústav, Praha

A differential diagnosis of idiopathic inflammatory myopathies covers several situations, which may lead to muscle weakness. In the classical dermatomyositis case, the diagnosis is not difficult, however, in many polymyositis cases, particularly in those non-responsive to treatment, it is always necessary to differentiate several other diseases. These include neurological disorders, muscle dystrophies, metabolic and endocrine diseases, mitochondrial myopathies, malignant diseases, sarcoidosis and also adverse reactions to drug treatments, such as with statins or fibrates. Myositis is often amenable to treatment with the use of higher doses of glucocorticoids, frequently with addition of immunosuppressive drugs, such as methotrexate, azathioprine, cyclosporine or cyclophosphamide.

Keywords: Key words: polymyositis, dermatomyositis, diagnosis, myopathy, treatment.

Published: January 1, 2006  Show citation

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Vencovský J. Differential diagnosis and treatment of idiopathic inflammatory myopathies. Interní Med. 2005;7(11):480-483.
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    References

    1. Bohan A, Peter JB. Polymyositis and dermatomyositis (First of two parts). N Engl J Med 1975; 292: 344-347. Go to original source... Go to PubMed...
    2. Coleman RA, Stajich JM, Pact VW, Pericak-Vance MA. The ischemic exercise test in normal adults and in patients with weakness and cramps. Muscle Nerve 1986; 9: 216-221. Go to original source... Go to PubMed...
    3. Dalakas MC. High-dose intravenous immunoglobulin in inflammatory myopathies: experience based on controlled clinical trials. Neurol Sci 2003; 24: S256-S259. Go to original source... Go to PubMed...
    4. Griggs RC, Askanas V, DiMauro S, et al. Inclusion body myositis and myopathies. Ann Neurol 1995; 38: 705-713. Go to original source... Go to PubMed...
    5. Hoogendijk JE, Amato AA, Lecky BR, et al. 119th ENMC International Workshop: Trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Netherlands. Neuromuscul Disord 2004; 14: 337-345. Go to original source... Go to PubMed...
    6. Joffe MM, Love LA, Leff RL, et al. Drug therapy of the idiopathic inflammatory myopathies: Predictors of response to prednisone, azathioprine, and methotrexate and a comparison of their efficacy. Am J Med 1993; 94: 379-387. Go to original source... Go to PubMed...
    7. Levine TD. Rituximab in the treatment of dermatomyositis: an open-label pilot study. Arthritis Rheum 2005; 52: 601-607. Go to original source... Go to PubMed...
    8. Love LA, Leff RL, Fraser DD, et al. A new approach to the classification of idiopathic inflammatory myopathy: Myositis-specific autoantibodies define useful homogeneous patients groups. Medicine 1991; 70: 360-373. Go to original source... Go to PubMed...
    9. Meola G, Moxley RT 3rd. Myotonic dystrophy type 2 and related myotonic disorders. J Neurol 2004; 251: 1173-1182. Go to original source... Go to PubMed...
    10. Miller FW, Leitman SF, Cronin ME, et al. Controlled trial of plasma exchange and leukapheresis in polymyositis and dermatomyositis. N Engl J Med 1992; 326: 1380-1384. Go to original source... Go to PubMed...
    11. Nirmalananthan N, Holton JL, Hanna MG. Is it really myositis? A consideration of the differential diagnosis. Curr Opin Rheumatol 2004; 16: 684-691. Go to original source... Go to PubMed...
    12. Riley P, Maillard SM, Wedderburn LR, Woo P, Murray KJ, Pilkington CA. Intravenous cyclophosphamide pulse therapy in juvenile dermatomyositis. A review of efficacy and safety. Rheumatology (Oxford) 2004; 43: 491-496. Go to original source... Go to PubMed...
    13. Rosenson RS. Current overview of statin-induced myopathy. Am J Med 2004; 116: 408-416. Go to original source... Go to PubMed...
    14. Taylor RW, Schaefer AM, Barron MJ, McFarland R, Turnbull DM. The diagnosis of mitochondrial muscle disease. Neuromuscul Disord 2004; 14: 237-245. Go to original source... Go to PubMed...
    15. Wortmann RL. Inflammatory diseases of muscle and other myopathies. In: Kelly WN et al. Textbook of Rheumatology. 5. vyd., WB Saunders Co, Philadelphia 1997: 1177-1206.
    16. Van der Meulen M, Bronner IM, Hoogendijk JE, et al. Polymyositis: an overdiagnosed entity. Neurology 2003; 61: 316-321. Go to original source... Go to PubMed...
    17. Vencovský J, Jarošová K, Charvát F. Využití magnetické rezonance v diagnostice a hodnocení aktivity idiopatických zánětlivých myopatií. Čes Revmatol 1997; 5: 163-168.
    18. Vencovský J. Therapeutic strategies in polymyositis and dermatomyositis. Drug Discov Today: Therapeutic Strategies 2004; 1: 369-374. Go to original source...
    19. Vencovský J, Jarošová K, Macháček S, et al. Cyclosporine A versus methotrexate in the treatment of polymyositis and dermatomyositis. Scand J Rheumatol 2000; 29: 95-102. Go to original source... Go to PubMed...
    20. Zámečník J, Manďáková P, Cibula A, et al. Je to skutečně myositida? Význam imunohistochemie svalové tkáně v diferenciální diagnostice zánětlivých myopatií. Čes Revmatol 2005; 13: v tisku.

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