Idiopathic inflammatory myopathies: difficulties of diagnosis
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 3
Abstract
The rapid development of basic researches in medicine in the last decade allowed a new approach to the etiopathogenesis of a number of diseases, which, in particular, include inflammatory myopathies. Idiopathic inflammatory myopathies (IIM) consist a group of chronic autoimmune conditions in which proximal muscle groups are primarily involved in the pathological process. The dermatomyositis, polymyositis, necrotic autoimmune myopathy and sporadic inclusions body myositis refer to the most prevalent types. This clinical review is devoted to the differential diagnosis of these clinical forms of IIMs, which is extremely important, since each subtype is characterized by an individual clinical course pattern and response to therapy. The manifesting signs of IIMs are subacute or chronic onset of muscle proximal weakness, manifested by the difficulty of lifting from a chair, climbing stairs, lifting objects and combing hair. In addition, extramuscular manifestations (interstitial lung disease, joint pain, Raynaud’s phenomenon, heart disease (arrhythmias, ventricular dysfunction, myocarditis), dysphagia) are characteristic of IIM. Laboratory studies, including elevated serum creatine phosphokinase levels and the presence of myositisspecific antibodies, can help to differentiate the clinical phenotype and confirm the diagnosis. There are quite specific signs of myopathy on electromyography, however, it is precisely muscle biopsy that remains the gold standard for IIM diagnosing. Improvement of the classification criteria, new possibilities of histopathological examination and visualization of muscles made it possible to improve the diagnosis of disease subtypes, which is extremely important, since early diagnosis and early initiation of therapy remain the cornerstone for optimal prognosis.
Authors and Affiliations
I. Yu. Golovach, Ye. D. Yehudina
Keywords
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- EP ID EP668873
- DOI 10.30978/UTJ2019-3-72
- Views 129
- Downloads 0
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