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Inflammatory Myopath
Inflammatory Myopathies lecture
Question | Answer |
---|---|
What are the different IIMs? | Polymyositis (PM), Dermatomyositis(DM), Inclusion body myositis(IBM), Paraneoplastic |
What are the common characteristics of IIM? | 1)Muscle weakness, 2)evidence of inflammation on muscle biopsy, 3)Responds to immunosuppressive therapy 4) Elevated muscle enzymes in serum 5) Reflexes normal |
What were the bohan and peter criteria for diagnosis of PM and DM? | 1)Symmetric proximal muscle weakness 2)Muscle biopsy evidence of myositis 3)Increase in serum skeletal muscle enzymes 4) Characteristic Electromyographic pattern 5)Typical rash of dermatomyositis |
How do you assess IIM? | 1)History 2) Manual muscle strength testing 3) Muscle enzymes 4) Serologies (90% +ANAs) 5)ESR 6)EMG 7)Muscle biopsy 8)MRI |
Which muscle enzymes do you check? | 1)CPK, 2)Aldolase 3)AST/ALT 4)LDH 5)Myoglobin |
What are the clinical features of DM and PM? (I) | Painless proximal muscle weakness over 3-6 months |
What are the clinical features of DM and PM? (II) | 1) Constitutional symptoms 2)Polyarticular arthralgia/arthiritis 3)Dysphagia 4)Dyspnea on exertion 5)Raynaud's phenomenon 6)Vasculitis 7)Malginancy |
Describe the general pathology of PM and DM. | 1)Inflammatory infiltrate 2)Degnerating and regenerating muscle fibers |
Describe the pathology of DM. | 1)Perivascular infiltrate of predominantly B cells and CD 14 cless located in a perifasicular or intrafasicular septae 2)Perifasicular atrophy 3)Capillaries stain for complement components |
Describe the pathology of PM. | Predominantly CD 8 positive surround and invade muscle fibers |
What is the name of the DM rashes? | 1)Heliotrope 2)V-sign 3)Gottron's papules 4)Nailfold capillary dropout 5)Mechanical hands |
What is the difference between IBM and (DM+PM) age of onset? | F>M 40-50's vs 50-60's M>F |
What are some of the lab featuers and pathology of IBM? | CPK<12x normal, EMB consistent with inflammatory myopathy, MNC invading fibers |
What is the pulmonary involvement of IIM? | Ventilatory muscle weakness, Aspiration pneumonia, ILD |
What is the association with malignancy? | The risk is increased |