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Polymyositis is a rheumatic disease in which the muscles become inflamed. All muscles are exposed to the attack of the disease, including e.g. the heart muscle and the muscles of the respiratory tract, which in the latter case can even lead to respiratory failure. What are the causes and symptoms of polymyositis? How is the treatment going?

Polymyositis(Latinpolymyositis , PM) is a rare rheumatic disease (specifically, systemic connective tissue disease) in which there is chronic inflammation in the muscles.

There are two forms of the disease: childhood, which affects between 10 and 15 years of age, and adult, which occurs in middle-aged people, more often in women (usually around 40) than in men .

Polymyositis - causes

The causes of polymyositis are unknown. It is suspected that immune system dysfunction may be responsible for the disease. Its cells attack the muscles, thereby causing them to become inflamed.

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It has been suggested that the disease can also be caused by some viruses, such as Coxsackie B, influenza, hepatitis B, C, HIV, cytomegalovirus. It was noticed that in some patients the symptoms of the disease appeared several weeks after the viral infection.

Some people may be genetically predisposed to develop polymyositis.

Polymyositis - symptoms

  • weakness
  • frequent low-grade fever
  • weight loss
  • muscle weakness (especially around the shoulder, hip, neck and back joints), which Difficulty walking up stairs, getting up from a chair, lifting heavier objects and performing other daily activities. Muscle pain and tenderness are also common
  • arthritis (in some cases)

The disease can also attack internal organs, e.g. the heart (characteristic is increased or slow heartbeat or palpitations), respiratory muscles (then coughing,shortness of breath, respiratory failure), and even the organ of vision (nystagmus and visual disturbances occur). If the muscles of the esophagus become inflamed, swallowing is reduced.

Polymyositis - diagnosis

If polymyositis is suspected, the following is done:

  • blood tests - in the case of myositis, the activity of serum muscle enzymes (creatine kinase, alanine aminotransferase and lactate dehydrogenase) is increased
  • electromyographic examination (EMG) - its recording is incorrect, which indicates muscle changes
  • Muscle Magnetic Resonance (MR) - to identify inflamed muscles
  • biopsy (a fragment of a muscle fragment) for histopathological examination. Under the microscope, inflammatory infiltrates as well as degenerative / regenerative changes and atrophies around the muscle bundles are visible

As an aid, X-rays of bones and joints can be performed. If it is suspected that internal organs have become inflamed, appropriate tests are performed. For example, in the case of lung involvement, it may be necessary to take an X-ray of the chest, and even to take a lung specimen for further examination.

This will be useful to you

A variety of polymyositis isdermatomyositis(Latin DM -dermatomyositis ), in which inflammation affects not only the muscles, but also the skin, especially of the face and limbs.

In patients with polymyositis and dermatomyositis, the risk of malignant neoplasm of the internal organ is increased (6 times higher in patients with DM, 2 times higher in patients with PM). Therefore, after the diagnosis of the disease, the patient should be under oncological control.

Polymyositis - treatment

Treatment includes glucocorticosteroids (usually prednisone) and consists of 3 phases: initiation, maintenance and long-term treatment. At the beginning of the initial phase, large doses of the drug are administered and then systematically reduced. In patients with high disease activity and in patients who can be predicted more likely to develop side effects, combined treatment is used, i.e. glucocorticosteroids are combined with another drug (most often azathioprine or methotrexate). If the patient does not respond to such treatment, intravenous infusions of immunoglobulins are given.

After recovery (usually 6 months from the start of treatment), maintenance treatment is applied to achieve complete remission (complete relief of disease symptoms) and prevent relapse. The maintenance phase lasts up to a year.

Healing phaselong-term, which lasts from one to three years, is the duration of remission maintenance and relapse prevention. In this phase, the lowest possible effective doses of drugs are used.

In addition, rehabilitation is necessary - preferably aerobic and general rehabilitation exercises (especially in water).

Bed rest is recommended during acute episodes of illness.

About the authorMonika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.

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