Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027121 (myositis)
 4,538 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-five percent to 50% of patients with polymyositis (PM) and dermatomyositis (DM) have autoantibodies that are specific for or associated with the presence of myositis. Because of a relatively low sensitivity for the diagnosis of PM or DM, these autoantibodies are inadequate as a screening test for PM or DM in patients with suspected inflammatory myopathy. However, they may be used to support the diagnosis of myositis, and they help exclude the diagnosis of inclusion body myositis in which autoantibodies are infrequent. In addition, these antibodies are associated with homogeneous syndromes with the following reproducible clinical features and prognosis: (I) the antisynthetases generally occur with moderately severe myositis, often in association with interstitial lung disease. Raynaud's phenomenon, and arthropathy; (2) anti-SRP is a marker of severe PM with associated cardiac disease and high mortality; (3) anti-Mi-2 occurs in generally corticosteroid-responsive DM associated with a potentially severe rash; and (4) the myositis-associated autoantibodies anti-PM-ScI and anti-Ku portend a moderately favorable prognosis. Anti-PH-Scl occurs in systemic sclerosis, often in association with arthropathy and Raynaud's syndrome. Anti-Ku occurs in systemic sclerosis and other connective tissue diseases with or without myositis. Thus, both myositis-specific and -associated antibodies have clinical use in the diagnosis of PM and DM and are predictive of certain clinical syndromes and responses to treatment.
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PMID:Myositis-specific and -associated autoantibodies: a review from the clinical perspective. 1907 2

Anti-thyroid drugs, like carbimazole and propylthiouracil (PTU) are commonly prescribed for the treatment of hyperthyroidism. One should be aware of the side effects of antithyroid medications. Antineutrophil cytoplasmic antibody (ANCA)--associated vasculitis is a potentially life-threatening adverse effect of antithyroidmedications. We report a patient with Graves' disease who developed ANCA positive carbimazole induced vasculitis. The episode was characterized by a vasculitic skin rash associated with large joint arthritis, pyrexia and parotiditis but no renal or pulmonary involvement. He was referred to us for neurological evaluation because he had difficulty in getting up from squatting position and was suspected to have myositis. Carbimazole and methimazole have a lower incidence of reported ANCA positive side effects than PUT. To the best of our knowledge this is the first ANCA positive carbimazole induced vasculitis case reported from India.
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PMID:Carbimazole induced ANCA positive vasculitis. 2032 22

Although hepatic dysfunction is common in adult-onset Still's disease (AOSD), sometimes it is difficult to differentiate hepatic dysfunction due to AOSD itself from drug-induced hepatic dysfunction. Further, myalgia often occurs in patients with AOSD; however, AOSD patients complicated with myositis are rare. We report a 43-year-old Japanese man with AOSD who developed myositis and hepatic dysfunction which were deteriorated by multiple nonsteroidal antiinflammatory drugs (NSAIDs) and were dramatically ameliorated by a low-dose steroid therapy. A skin biopsy of salmon pink rash which is characteristic for AOSD showed leukocytoclastic vasculitis, and the markers for vasculitis, plasma von Willebrand factor, and vascular endothelial growth factor levels were elevated in this patient, suggesting an association between AOSD and systemic vasculitis.
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PMID:Myositis, Vasculitis, Hepatic Dysfunction in Adult-Onset Still's Disease. 1971 45

Dermatomyositis is an unknown cause's disease that in general is characterized by muscular inflammation with weakness and typical skin rash (heliotrope and Gottron's papules). In this article we describe a 13-year-old girl with juvenile dermatomyositis associated with toxoplasmosis. Myositis was treated with corticosteroids and immunosuppressive drugs, but she had good response only after anti-parasitary drug was started.
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PMID:[Juvenile dermatomyositis and toxoplasmosis: a rare association]. 1982 Jun 79

A new autoantibody against a 155-kDa protein has been described in patients with myositis. We conducted a study to determine the occurrence and types of cancer occurring in a cohort of patients with polymyositis (PM) or dermatomyositis (DM) and analyzed the value of this autoantibody as a serologic marker of cancer-associated myositis (CAM). Serum samples from all patients were examined by protein immunoprecipitation assays with HeLa cells to determine the presence of a 155-kDa protein band. HLA-DRB1 and DQA1 typing was performed by polymerase chain reaction-reverse sequence specific oligonucleotide. Statistical analyses were carried out with the Mann Whitney U and Fisher exact tests. Associations were determined using odds ratios (ORs) with 95% confidence intervals (CI). Eighty-five patients with myositis (20 PM and 65 DM) were included. CAM was detected in 16 patients (19%), 14 with DM. The shawl sign rash was significantly more frequent in patients with CAM than in those without (p < 0.01). Adenocarcinoma was the most frequent type of cancer (87.5%). Anti-p155 autoantibody was found in 1 of the 20 (5%) patients with PM and in 15 of the 65 (23%) patients with DM. A relationship between anti-p155 and CAM was found in DM patients (OR, 23; 95% CI, 5.23-101.2). The HLA-DQA1*0102 allele was not found in any of the anti-p155-positive patients. The prevalence of CAM in our cohort was 19%. Autoantibody against p155 was highly related to CAM and could be a reliable marker of cancer in patients with DM.
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PMID:Cancer-associated myositis and anti-p155 autoantibody in a series of 85 patients with idiopathic inflammatory myopathy. 2007 4

A 61-year-old Caucasian was admitted to Department of Chest Diseases and Tuberculosis, Medical University of Bialystok, Poland for progressive muscle weakness and weight loss. Eighteen months prior to admission, the patient had been diagnosed with pulmonary embolism. At that point he was started on Enoxaparin QD. Past medical history was unremarkable. In the interim, the patient developed fever, myalgia and progressive dyspnea. Physical examination on admission revealed a rash on his upper torso and back, and the extensor surfaces of all four extremities. Laboratory values included CPK 8229, MB fraction 219, LDH 981. Chest X-ray and CT scan revealed bilateral patchy consolidations and ground-glass opacities. EMG was consistent with myositis. The patient was started on solumedrol 40 mg i.v., b.i.d., and then switched to prednisone 40 mg b.i.d. His symptoms and muscle strength improved remarkably. The patient was discharged with prednisone with an outpatient follow up.
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PMID:Dermatomyositis masquerading as pulmonary embolism. 2015 49

Drug hypersensitivity syndrome (DHS) is an adverse drug reaction commonly associated with the aromatic antiepileptic drugs (AEDs), viz., phenytoin (PHT), carbamazepine (CBZ), phenobarbital (PB), lamotrigine, primidone, etc. It can also be caused by other drugs, such as sulfonamides, dapsone, minocycline, gold derivatives, cyclosporine, captopril, diltiazem, terbinafine, azathioprine and allopurinol. Diagnosis of DHS may be difficult because of the variety of clinical and laboratory abnormalities and manifestations and because the syndrome may mimic infectious, neoplastic or collagen vascular disorders. The risk for developing hypersensitivity within 60 days of the first or second prescription in new users of PHT or CBZ was estimated to be 2.3-4.5 per 10,000 and 1-4.1 per 10,000, respectively. The syndrome is defined by the fever, skin rash, lymphadenopathy and internal organ involvement within the first 2-8 weeks after initiation of therapy. Internal manifestations include, among others, agranulocytosis, hepatitis, nephritis and myositis. Insufficient detoxification may lead to cell death or contribute to the formation of antigen that triggers an immune reaction. Cross-reactivity among PHT, CBZ and PB is as high as 70%-80%. Management mainly includes immediate withdrawal of the culprit drug, symptomatic treatment and systemic steroids or immunoglobulins.
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PMID:Drug hypersensitivity syndrome. 2122 Aug 73

The inflammatory myopathies are a heterogeneous group of diseases including dermatomyositis, polymyositis, and inclusion body myositis. Few clinical trials have been conducted in myositis, making it difficult to provide clear recommendations on the treatment of these rare disorders. Although corticosteroids have not been tested in randomized controlled trials, the general expert consensus confirms their first-line use. However, in many patients, corticosteroid toxicity leads to significant disability, or these agents are ineffective, which then requires additional immunosuppression. Intravenous immunoglobulin is a reasonable short-term treatment with proven benefit in a controlled trial, but its long-term effectiveness remains unknown. The evidence for other immunosuppressive therapies has been derived mainly from case reports and open studies. These agents include methotrexate and/or azathioprine, followed by cyclosporine or tacrolimus (particularly for antisynthetase antibody-positive patients) and mycophenolate mofetil (for refractory rash). Newer therapies (eg, rituximab) are encouraging, but results from the largest randomized controlled trial studying this agent are soon to follow. The balance of evidence suggests that immunosuppressive drugs are effective in dermatomyositis and polymyositis, although randomized controlled trials are lacking.
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PMID:Therapeutic approaches in myositis. 2136 10

A 49-year old woman noticed her skin rash several days after taking supplements containing Spirulina, a planktonic blue-green alga. Her skin rash was spreading over large parts of her body, even after stop ingestion two months later. Five months later, she developed muscle weakness of neck flexor and left proximal upper extremity. On admission, creatine kinase (CK) was elevated to 1,268 IU/ml in the serum. A muscle specimen revealed many necrotizing muscle fibers and the infiltration of mononuclear cells in the peri- and endomysium including a lot of eosinophils. Immunohistochemical staining showed the infiltration of CD4 positive cells in the peri- and endomysium and that of CD20 positive B cells in the perivascular regions. She was diagnosed as having inflammatory myopathy with widely skin rash. Therapy with administration of prednisolone and cyclophosphamide followed by methyl-prednisolone pulse improved her clinical symptoms. There is a similar report describing a case of dermatomyositis after ingestion of Spirulina, which is known to have immune-stimulating property such as accelerating tumor necrosis factor (TNF)-alpha production. Also, TNF-alpha single nucleotide polymorphisms (TNF-308A) was demonstrated to have strong association with onset of myositis in Caucasians. The use of Spirulina could result in inflammatory myopathy under some specific conditions.
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PMID:[A case of inflammatory myopathy with widely skin rash following use of supplements containing Spirulina]. 2170 29

We present a case of a 47-year-old man with mediastinal cancer manifesting as a rash, myaLgia and muscle weakness, in addition to the typical laboratory test results and histological changes compatible with dermatomyositis. The skin and muscLe findings followed the relapse of cancer which responded well to a combination of chemo and radiation therapy. Disease prevaLence in Rambam MedicaL Center during the past decade is also described. Dermatmyositis is a myositis with cutaneous manifestations. In a significant percent of the cases it can occur as a paraneoplastic syndrome. It was described as coetisting with various cancers, mostly adenocarcinomas. The majority of the cases occur in males above the age of 45 years. Malignancy can occur simultaneously with dermatomyositis or up to 3 years thereafter. Ovarian cancer is an exception, for it can be diagnosed up to six years after dermatomyositis. Therefore, it is advised to perform cancer screening in adult patients with dermatomyositis. Screening shouLd incLude extensive laboratory and imaging work-up. However, the mechanisms underlying paraneoplastic dermatomyositis are not fully understood. A possible antigenic similarity between cancer cell popuLations and regenerating myoblasts is suggested; this can result in an autoimmune autoantibody-mediated response in genetically predisposed patients. Numerous laboratory and clinical characteristics are associated with a high risk of malignancy. An update on paraneoplastic dermatomyositis is provided.
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PMID:[Mediastinal cancer presenting as dermatomyositis--a case report]. 2187 66


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