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POLYMYOSITIS
Dr.QURA_TUL_AIN
CONTENTS
DEFINITION
ETIOLOGY
PATHOGENISIS
SYMPTOMS AND SIGNS
INVESTIGATIONS
MANAGEMENT
PROGNOSIS
DEFINITION
Polymyositis is an idiopathic inflamatory myopathy
that causes symmetrical proximal muscle weakness,
elevated s...
ETIOLOGY
Polymyositis is an immune-mediated syndrome secondary
to defective cellular immunity that is most commonly
associ...
CLASSIFICATION
PATHOGENSIS
SYMPTOMS
Proximal muscle weakness of both upper
and lower limbs causes
Difficulty in raising arms,lifting objects
and com...
EXTRA SKELETAL SYMPTOMS
 GIT
Dysphagia(30%)
Bloating
Concipation
 Cardiac
Arrythmias
Conduction defects
 Pulmonary...
 Renal
 Acute tubular necrosis
 Joint involvement
 Arthralgia(5-25%)
INVESTIGATIONS
1. CBC
• Leukocytosis(50%)
1. ESR
2. Elevated muscle enzyme
level(CK,LDH,AST,ALT,ALDOLASE)
3. Antibody Find...
DIFFERENTIAL DIAGNOSIS
 Cushing Syndrome
 Fibromyalgia
 Hyperthyroidism
 Hypothyroidism
 Polymyalgia Rheumatic
 Rheu...
TREATMENT
1. Corticosteroids
• Prednisolone(1mg/kg/day for 4to8 weeks)
• Monitor the response by
• Muscle Strength
• CK Le...
3. Other Agents
Intravenous immunoglobulin (IVIG)
TNF inhibitors(infliximab)
anti-CD20 monoclonal antibody(rituximab)
4. D...
DERMATOSITIS
DEFINITION:-
Dermatomyositis is an idiopathic inflammatory myopathy
with characteristic cutaneous findings.
E...
PATHOGENSIS
Dermatomyositis is considered to be the result of a humoral attack
against the muscle capillaries and small ar...
SYMPTOMS
 Proximal Muscle Weakness
 Skin Manifestations
 Systemic Systems
SIGNS
 Heliotrope Rash
 Gottron Papules
 D...
TREATMENT
 GENERAl MEASuRES:-
 Diet
 Physiotherapy
 Skeletal muscle weakness
 Prednisone (0.5-2mg/kg/day)
 Methotrex...
TREATEMENT OF SKIN DISEASES
FIRST lINE THERAPY
 Sun avoidance
 Sun protection measures
 Hydroxychloroquine/chloroquine
...
Polymyositis
Polymyositis
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Polymyositis

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Polymyositis

  1. 1. POLYMYOSITIS Dr.QURA_TUL_AIN
  2. 2. CONTENTS DEFINITION ETIOLOGY PATHOGENISIS SYMPTOMS AND SIGNS INVESTIGATIONS MANAGEMENT PROGNOSIS
  3. 3. DEFINITION Polymyositis is an idiopathic inflamatory myopathy that causes symmetrical proximal muscle weakness, elevated skeletal muscle enzyme levels,characteristic electromyograhic pattern and muscle biopsy findings.
  4. 4. ETIOLOGY Polymyositis is an immune-mediated syndrome secondary to defective cellular immunity that is most commonly associated with other systemic autoimmune diseases. It may be due to diverse causes that occur alone or in association with   Viral infections  Malignancies  Drugs
  5. 5. CLASSIFICATION
  6. 6. PATHOGENSIS
  7. 7. SYMPTOMS Proximal muscle weakness of both upper and lower limbs causes Difficulty in raising arms,lifting objects and combing hairs Difficulty in climbing and descending stairs,sitting on curb and raising from sitting posture
  8. 8. EXTRA SKELETAL SYMPTOMS  GIT Dysphagia(30%) Bloating Concipation  Cardiac Arrythmias Conduction defects  Pulmonary Aspiration pneumonia Interstitial lung disease(Anti jo-1) Bronchiolitis obliterans
  9. 9.  Renal  Acute tubular necrosis  Joint involvement  Arthralgia(5-25%)
  10. 10. INVESTIGATIONS 1. CBC • Leukocytosis(50%) 1. ESR 2. Elevated muscle enzyme level(CK,LDH,AST,ALT,ALDOLASE) 3. Antibody Findings(ANA,Myositis Specific Antibodies) 4. Electromyography(EMG) 5. Muscle Biopsy
  11. 11. DIFFERENTIAL DIAGNOSIS  Cushing Syndrome  Fibromyalgia  Hyperthyroidism  Hypothyroidism  Polymyalgia Rheumatic  Rheumatoid Arthritis  Sarcoidosis  SLE
  12. 12. TREATMENT 1. Corticosteroids • Prednisolone(1mg/kg/day for 4to8 weeks) • Monitor the response by • Muscle Strength • CK Levels • Immunosuppressive Agents • Indications • No response with steroids upto 4 weeeks • Extra Skeleton Manifestations •  Azathioprine, cyclophosphamide, chlorambucil, and cyclosporine
  13. 13. 3. Other Agents Intravenous immunoglobulin (IVIG) TNF inhibitors(infliximab) anti-CD20 monoclonal antibody(rituximab) 4. Diet 5. Activity 6. Consultations Cardiologist Radiologist
  14. 14. DERMATOSITIS DEFINITION:- Dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous findings. ETIOLOGY:-  Genetic  Immunologic  Infectious  Environmental
  15. 15. PATHOGENSIS Dermatomyositis is considered to be the result of a humoral attack against the muscle capillaries and small arterioles (endothelium of the endomysial blood vessels).
  16. 16. SYMPTOMS  Proximal Muscle Weakness  Skin Manifestations  Systemic Systems SIGNS  Heliotrope Rash  Gottron Papules  Dilated capillary loops at base of finger nails
  17. 17. TREATMENT  GENERAl MEASuRES:-  Diet  Physiotherapy  Skeletal muscle weakness  Prednisone (0.5-2mg/kg/day)  Methotrexate,Azathioprine,Cyclophosphamide,Cyclospor ine,Mycophenolate mofetil,Leflunomide,Chlorambucil
  18. 18. TREATEMENT OF SKIN DISEASES FIRST lINE THERAPY  Sun avoidance  Sun protection measures  Hydroxychloroquine/chloroquine  Methotrexate is fist line therapy if anti malarial are contraindicated  Consultation

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