Seminar G Dermatomyositis and Polymyositis Flashcards Preview

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Flashcards in Seminar G Dermatomyositis and Polymyositis Deck (17)
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1
Q

Definition

A

Polymyositis is an autoimmune disease characterised by inflammation of striated muscle.

2
Q

Epi

A

2-10 per million/yr

3
Q

Female:Male

A

2.5:1

4
Q

Peak mean ages

A

Childhood and 40-50 years

5
Q

Aetiology and Pathogenesis

A

Associations with HLA-DR3 and Drw52

First degree relatives

6
Q

Environmental factors

A

More common in winter and spring
Influenxa
Coxsackie
Echo

7
Q

Drug induced myositis

A

HMG-CoA reductase inhibitors (Statins)
D-penicillamine
Chloroquine

8
Q

Hallmark Feature

A

Painless proximal muscle weakness

9
Q

More advanced disease

A

Pharyngeal musculature result difficulty in initiating swallowing, whilst exertional dyspnoea may result from respiratory muscle weakness.

10
Q

MRC motor scale

A

May be used to record muscle power

11
Q

Blood tests

A

Acute phase response, with a raised ESR or plasma viscosity
Anaemia
Muscle enzymes will be grossly elevated, as they leak from damaged skeletal muscle.

12
Q

Creatine Kinase (CK)

A

Most sensitive and best guide to muscle inflammation, but other enzymes such as lactate dehydrogenase, and the transaminases (ALT and AST) may

13
Q

Autoimmune profile may show

A
Positive Antinuclear (ANA) and anti-Jo-1 antibodies may also be present.
An electromyogram
14
Q

Treatment → Symptoms

A

Oral prednisolone

15
Q

Treatment → Other Agents

A

Azathioprine

Methotrexate

16
Q

Treatment → Prevent glucocorticoid-induced osteoporosis

A

Bisphosphonates

17
Q

Association with Malignancy →
Underlying neoplastic lesions seen in 10-15% of cases in the first 6 months.
Examples:

A
  1. Adenocarcinoma of the colon
  2. Prostatic carcinoma
  3. Ovarian tumours
  4. Breast cancers

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