• Lab studies and serologies in myositis
  • ESR/CRP not typically elevated in myositis, especially compared to other autoimmune disorders
  • Aldolase is used as a marker in myositis, especially if CPK is not significantly elevated, and followed during the disease course
  • Anti-Jo-1, one of the myositis specific autoantibodies, is relatively specific for polymyositis or dermatomyositis
  • Myositis panel is sent to find other specific autoantibodies
  
  

  Posted 11/09/16 02:08:42 PM by Anna Krigel

• Major cause of death in myositis = ILD and right heart failure
  
  Causes of SOB in myositis
  • chest wall weakness - can observe on PFTs
  • dysphagia and aspiration pneumonitis
  • ILD
  
  

  Posted 11/09/16 05:18:45 PM by Anna Krigel

• Appearance on tissue biopsy
  • Polymyositis = perivesicular inflammation (inflammation of muscle bundles)
  • Dermatomyositis = perivascular inflammation (inflammation of muscle vasculature)
  
  

  Posted 11/09/16 05:20:21 PM by Anna Krigel

• Management of dermatomyositis
  • recommend age-appropriate cancer screening, often do pan-CT scanning if patient is a smoker
  • start high dose steroids for about 1 month, then taper slowly once CPK and aldolase normalize
  • can maintain on mTX
  
  

  Posted 11/09/16 05:21:35 PM by Anna Krigel

• For further reading...

  Inflammatory Muscle Diseases (NEJM)
  
  

  Posted 11/09/16 05:23:18 PM by Anna Krigel

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