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)

The new antivirals clevudine, telbivudine and emtricitabine may be potent agents for the treatment of hepatitis B virus (HBV). However, there have been no reports on serious adverse events associated with the use of clevudine. A son and his mother both had HBV infection (ages: 27 and 47 years, respectively), and they had received antivirus treatment with clevudine (30 mg daily). They developed progressive weakness of the lower extremities and difficulty arising from the ground. Both the patients had symptoms for the previous 3 approximately 4 months in process of 14 approximately 17 months of clevudine therapy. The physical examinations showed positive Gower's sign, a decreased gait velocity and symmetrical proximal weakness (MRC grade 4/5). Their blood tests at admission revealed elevated or positive HBs Ag, HBV DNA, AST, ALT, creatine kinase, LDH, myoglobin and CK-MB. For both patients, the electrodiagnostic studies indicated myopathy and the pathologic findings of biopsied muscles revealed myositis. Drug-induced polymyositis was suspected and the clevudine was finally withdrawn. The muscle weakness and laboratory findings were improved for both patients after conservative care. We report here on the first cases of polymyositis that may have been caused by administering the new nucleoside analog clevudine for treating HBV infection.
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PMID:Polymyositis in patients taking antiviral clevudine therapy: a report of two cases. 2020 82

Myositis during interferon therapy is a known but rare adverse event. However the clinician may overlook the symptom-complex of proximal muscle weakness and myalgia, seen in myositis, since myalgia is a commonly reported side effect of therapy. In this context then, is there a role for monitoring muscle enzymes to detect subclinical myositis in patients on interferon therapy? We prospectively monitored the creatine kinase (CK) and lactate dehydrogenase (LD) levels in all our patients who reported myalgia during treatment and noted that muscle enzymes remained within normal range throughout the duration of treatment. This excluded the possibility of subclinical myositis in myalgic patients and thus led us to conclude that routine monitoring of muscles enzymes is neither necessary nor beneficial.
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PMID:Myalgia during interferon therapy--does it warrant monitoring muscle enzymes? 2030 56

Statins are effective in the treatment of hypercholesterolemia for primary and secondary prevention of cardiovascular disease. While most side effects of statins are mild and transient, muscular symptoms are relatively common (5 to 10% of patients), but rarely serious (myositis, rhabdomyolysis). In cases of myopathy, the severity of symptoms and the determination of CK (creatine kinase) determine whether discontinuation of statin is necessary. Alternative strategies are also suggested. This article reviews suggestions on the management of these complaints that are a challenge in clinical practice.
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PMID:[Statins and muscular side-effects]. 2037 98

To study the source and clinical relevance of elevated cardiac troponin-T (cTnT) in patients with inflammatory myositis of varying etiology is the objective of this study. Patients with new-onset myositis of varying etiologies and raised serum cTnT and creatine kinase (CK) were identified. Clinical myocardial disease was ruled out on the basis of history, examination, ECG, and 2D-echocardiography. Along with serial estimation of CK levels, cTnT isoforms specific to myocardium (by electrochemiluminescence immunoassay) were used for serial estimation of cTnT levels. Gel-filtration chromatography was performed to investigate the nature of elevated cTnT in myositis patients compared to that in acute coronary syndrome (ACS). Patients requiring hospitalization due to an indication related to myositis were classified as having severe disease. All patients received conventional management for myositis as indicated in individual cases. Eleven patients (eight women, three men; aged 59-87 years) with polymyositis (five), dermatomyositis (three), statin-induced myopathy (two), and inclusion body myositis (one) were studied. The cTnT in myositis patients was found to be identical to cTnT in ACS. The time kinetics of cTnT was different from CK and their levels did not correlate. While CK normalized with treatment, cTnT levels exhibited prolonged elevation. Nine of the patients with raised cTnT had severe disease despite absence of clinical myocardial disease. Three died. cTnT in sera of patients with inflammatory muscle disease is of cardiac origin. It may identify a subgroup with subclinical myocardial involvement with differential response to treatment compared to skeletal muscle. We feel cTnT is an important laboratory investigation in patients with myositis.
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PMID:Clinical observations on the significance of raised cardiac troponin-T in patients with myositis of varying etiologies seen in rheumatology practice. 2055 54

Cardiovascular diseases are the most common causes of death in Germany and the prevalence is increased in patients with inflammatory rheumatic diseases. Statins are often employed for primary and secondary prophylaxis of cardiovascular events but can potentially induce myopathy as a side-effect. In addition to an asymptomatic elevation of muscle enzymes, myalgia and myositis as well as rhabdomyolysis, the most severe side-effect, have been observed, which are mostly manifested within 6 months after initiation of therapy. Statin-induced myopathy is rare but if risk factors are present, the individual risk can be much higher. Such factors are in particular interaction with other medications, statin dosage, the characteristics of the statin preparation used, comorbidities, age and sex of the patient. Regular testing of muscle enzymes after induction of statin therapy is not generally recommended for asymptomatic patients, but is indispensable when muscle symptoms appear. Statin therapy must be immediately terminated and a diagnostic evaluation must be carried out at the latest when creatine kinase values show a more than 10-fold increase.
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PMID:[Current views on lipid metabolism: statin-induced myopathy]. 2086 81

Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK), serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.
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PMID:Acute dengue myositis with rhabdomyolysis and acute renal failure. 2108 38

We present a female with anti-Jo-1 positive polymyositis and lung adenocarcinoma. Her polymyositis diagnosis was based on her clinical symptoms, electromyography results, and highly elevated muscle enzymes, including creatine kinase and lactate-dehydrogenase. Anti-Jo-1 positivity, leukocytosis and elevated tumor markers: CA 15-3 and CA 72-4 were also certified at the diagnosis. Her malignancy was finally diagnosed by transthoracic needle biopsy, two years after the appearance of first symptoms of polymyositis. After surgical removal of the tumor, polymyositis was in remission. Due to the symptoms mentioned above and the coincidence of the tumor, a paraneoplastic myositis was suspected.
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PMID:Primary lung adenocarcinoma associated with anti-Jo-1 positive polymyositis. 2109 73

Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with transaminase levels no more than three times the upper limit of normal can continue taking statins; often the elevations will resolve spontaneously. Coexisting elevations of transaminase levels from nonalcoholic fatty liver disease and stable hepatitis B and C viral infections are not contra- indications to statin use. Although myalgias are common with statin use, myositis and rhabdomyolysis are rare. When prescribed at one-half the recommended maximal dosage or less, statins are associated with an incidence of myopathy similar to that of placebo; therefore, rou- tine monitoring of creatine kinase levels in asymptomatic patients is not recommended. Myopathic symptoms usually resolve approximately two months after discontinuing the statin, and the same statin can be restarted at a lower dosage, or patients can try a different statin. Clinically important drugs that interact with statins and increase the risk of adverse effects include fibrates, diltiazem, verapamil, and amiodarone.
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PMID:Considerations for safe use of statins: liver enzyme abnormalities and muscle toxicity. 2140 82

Carrier woman of Duchenne muscular dystrophy (DMD) can mimic the inflammatory myositis in presenting symptoms. Two diseases should be differentiated by the clinical history, muscle biopsy and genetic study. There are few reports in which both histochemical and genetic study showed the possible link of overlapping inflammatory pathophysiology with dystrophinopathy. We report a 40-yr-old woman who presented with subacute proximal muscle weakness and high serum level of creatine kinase. She had a history of Graves' disease and fluctuation of serum liver aminotransferase without definite cause. MRI, EMG and NCV were compatible with proximal muscle myopathy. Muscle biopsy on vastus lateralis showed suspicious perifascicular atrophy and infiltration of mono-macrophage lineage cells complicating the diagnosis. Dystrophin staining showed heterogeneous diverse findings from normal to interrupted mosaic pattern. Multiple ligation probe amplification and X chromosome inactivation test confirmed DMD gene deletion mutation in exon 44 and highly skewed X inactivation.
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PMID:Carrier woman of Duchenne muscular dystrophy mimicking inflammatory myositis. 2146 71

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


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