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Query: UMLS:C0011633 (dermatomyositis)
 4,181 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Out of 97 patients with circulating ribonucleoprotein antibodies, 44 (45%) satisfied the criteria for systemic sclerosis, systemic lupus erythematosus, polymyositis/dermatomyositis, or rheumatoid arthritis. Forty-two (43%) of the 97 patients whose cases did not fulfill these criteria had at least two of the following three clinical manifestations: arthritis, Raynaud's phenomenon, and swollen or sclerotic fingers. A fifth of the latter group of patients had chronic, restrictive pulmonary disease or myopathy and two thirds had hypergammaglobulinemia, IgM rheumatoid factor, and sensitized epidermal nuclei. Few patients had hypocomplementemia. One patient had nephropathy. Most patients had an unchanged, benign disease course for, on the average, nine years. It is suggested that the term mixed connective tissue disease (MCTD) be reserved for such patients, and that the acronym MCTD be changed to SRA (swollen fingers, Raynaud's phenomenon, and arthritis). Treatment with glucocorticoids is necessary for only a minority of patients.
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PMID:Clinical implications of ribonucleoprotein antibody. 349 41

A patient presenting with interstitial lung disease was predicted to have underlying polymyositis when found to be anti-Jo-1 antibody positive. When myopathy developed later with elevated serum creatine phosphokinase and myoglobin levels, the electromyogram was nonmyopathic, and polymyositis was confirmed by muscle biopsy. The case illustrates the value of anti-Jo-1 as a 'marker' autoantibody for polymyositis, and the need for thorough investigation of patients with interstitial lung disease of uncertain etiology. This should include indirect immunofluorescence using a dividing cell substrate and tests for antibodies to extractable tissue antigens. The need to completely evaluate patients with dermatopolymyositis is also emphasised.
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PMID:Interstitial lung disease as the presentation of anti-Jo-1 positive polymyositis. 349 60

Strength of the quadriceps and hamstring groups was biomechanically assessed in terms of isometric torque production in 14 patients with inflammatory myopathy. Eleven had polymyositis and 3, dermatomyositis. Determinations of serum creatine kinase, lactate dehydrogenase, transaminase, and myoglobin were simultaneously obtained over an average period of observation of 1.8 years. In certain individual patients, there were significant correlations between laboratory indices and strength during the entire course of illness. In others, this was not the case. In the total group of patients, absolute values of the laboratory indices did not correlate well with strength except in the case of serum myoglobin, where there a significant inverse relationship. Logarithmic transformations of the laboratory data increased the inverse correlations. High strength and low myoglobin were related to high prednisone dose. Since laboratory guides are not always related to disease activity, quantitative assessment of muscle strength is necessary.
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PMID:Serum enzyme, myoglobin and muscle strength relationships in polymyositis and dermatomyositis. 372 97

This study quantitatively assessed skeletal muscle histopathology in 57 patients with inflammatory myopathy, including 20 patients with polymyositis (PM), 19 patients with dermatomyositis (DM), and 18 patients with evidence of an additional connective-tissue disease. No histologic criteria for invariably distinguishing patients with inflammatory myopathy were established because of overlap in individual measurements, but general histopathologic distinctions were confirmed. In PM, endomysial mononuclear cell infiltration (fibers bordering on inflammation) was usual, whereas in DM inflammation of large vessels, fibers with circumscribed areas of myofibrillar loss, and perifascicular atrophy were seen. Patients with evidence of an additional connective-tissue disease were most similar to the DM patients, with a greater prevalence of perivascular inflammation than in the PM patients. Because of varying histopathology (and presumed varying pathogenesis), future therapeutic trials would be more informative if they were designed using patients with homogeneous histologic features.
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PMID:Quantitative histopathology of the inflammatory myopathies. 375 61

Dermatomyositis must be differentiated from a number of other diseases, including lupus erythematosus, myxedema, and contact dermatitis. Mixed connective-tissue disease also may be seen as a proximal myopathy and has similar skin findings. Satisfactory treatment of the underlying malignancy often results in disappearance or easier control of the dermatomyositis. The initial treatment step, however, is high-dose corticosteroids combined with oral immunosuppressives to control muscular and cutaneous inflammation.
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PMID:A skin marker for geriatric cancer. 394 66

Of 105 cases seen over 12 years with mean 4 years followup, there were 69 with polymyositis (PM) and 36 with dermatomyositis (DM). and in 43 this complicated another connective tissue disease (CTD). Primary PM had onset a decade later than others and most severe myopathy occurred in DM. Earliest symptoms were polyarthritis and Raynaud's phenomenon with frequent sicca syndrome (51%). The less than universal prevalence of elevated muscle enzymes (68%), myopathic electromyography (86%). and abnormal muscle biopsy (78%) emphasizes the need for complete evaluation in all cases. Improvement occurred in 69% overall, including all 23 given no therapy or low dose corticosteroids and 59% of the remainder who received high dose corticosteroids with added cytotoxics in one-quarter. Outcome was worse in older patients and in those where weakness exceeded 4 months before diagnosis. Eight of 19 deaths were due to myositis or its therapy which also caused considerable morbidity. Malignancy in 16 cases was temporally related to myositis in half of these cases.
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PMID:Dermatopolymyositis and other connective tissue diseases: a review of 105 cases. 409 21

Immunosuppressive drugs were given to seven patients with polymyositis. The in-vitro activity of peripheral blood lymphocytes had previously been studied in five of these patients with findings suggestive of disturbed immunological processes. Some improvement occurred in five cases, but only in two was the improvement marked and sustained. In this small series of cases, the response to treatment was best in a patient with polymyositis who showed no evidence of involvement of tissues or organs other than muscle and in a second case with subacute polymyositis occurring in association with an unidentified connective tissue disorder. The response was less satisfactory in two patients with dermatomyositis, in two with polymyositis associated with systemic sclerosis, and in one in whom the muscle disorder complicated rheumatoid arthritis. At present such treatment is usually given only in cases which are resistant to, or intolerant of, steroids. The relative values of steroid and immunosuppressive therapy are discussed; a combination of the two in moderate doses may eventually prove to be the best initial treatment for the disorder.
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PMID:Immunosuppressive therapy in polymyositis. 509 59

We studied a young woman with an eating disorder. To induce vomiting, she took syrup of ipecac daily for 2 years, and then developed insidious, progressive muscle weakness. Skin findings were similar to those of dermatomyositis. Muscle biopsy, however, was similar to experimental emetine myopathy and lacked inflammatory features. Upon cessation of ipecac abuse, strength returned. We believe that this patient had ipecac-induced muscle weakness.
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PMID:Ipecac-induced myopathy simulating dermatomyositis. 611 51

The immunopathogenetic mechanisms associated with the development of inflammatory myopathies are not well defined. In order to identify cells in affected muscle tissue, mononuclear cells infiltrating muscle biopsies from patients with inflammatory myopathies and controls with other neuromuscular diseases were analyzed in situ by an avidin-biotin immunoperoxidase technique. Serial frozen sections were stained for cells expressing total T, helper-induced T, suppressor-cytotoxic T, B, monocyte/macrophage, and HLA-DR phenotypes. A significant increase in the percentage of helper-inducer T cells are noted in the inflammatory myopathies when compared to the disease control group. Furthermore, most of the mononuclear cells in the inflammatory myopathy biopsies were HLA-DR positive, suggesting that the infiltrating T lymphocytes were activated. No significant differences in mononuclear cell distributions were found when the inflammatory myopathy group was broken down into individual groups of patients with polymyositis, polymyositis with associated connective tissue disease, and dermatomyositis.
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PMID:Immunohistochemical characterization of the mononuclear cells infiltrating muscle of patients with inflammatory and noninflammatory myopathies. 623 Jan 85

Polydermatomyositis is a chronic, non-suppurative disease of the striated muscle. In practice, the diagnostic criteria are often associated with other factors--alcoholism, corticotherapy--which, by themselves, may induce myopathy. In adults, the possible association of dermatomyositis with cancer rises the problem of scanning for neoplasia at regular intervals. In addition to corticotherapy, physical therapy helps the patient to maintain maximal autonomy.
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PMID:[Polydermatomyositis in the adult and its management]. 630 94


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