Polymyositis

Polymyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness.  Polymyositis affects skeletal muscles (those involved with making movement) on both sides of the body.  It is rarely seen in persons under age 18; most cases are in adults between the ages of 31 and 60.  Progressive muscle weakness starts in the proximal muscles (muscles closest to the trunk of the body) which eventually leads to difficulties climbing stairs, rising from a seated position, lifting objects, or reaching overhead.  People with polymyositis may also experience arthritis, shortness of breath, difficulty swallowing and speaking, and heart arrhythmias.  In some cases of polymyositis, distal muscles (muscles further away from the trunk of the body, such as those in the forearms and around the ankles and wrists) may be affected as the disease progresses.  Polymyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus.  Polymyositis may also be associated with infectious disorders, such as HIV-AIDS.

Is there any treatment?

There is no cure for polymyositis, but the symptoms can be treated.  Options include medication, physical therapy, exercise, heat therapy (including microwave and ultrasound), orthotics and assistive devices, and rest.  The standard treatment for polymyositis is a corticosteroid drug, given either in pill form or intravenously.  Immunosuppressant drugs, such as azathioprine and methotrexate, may reduce inflammation in people who do not respond well to prednisone.  Periodic treatment using intravenous immunoglobulin can also improve recovery.  Other immunosuppressive agents used to treat the inflammation associated with polymyositis include cyclosporine A, cyclophosphamide, and tacrolimus.  Physical therapy is usually recommended to prevent muscle atrophy and to regain muscle strength and range of motion. 

What is the prognosis?

The prognosis for polymyositis varies.  Most people respond fairly well to therapy, but some have a more severe disease that does not respond adequately to therapies and are left with significant disability.  In rare cases individuals with severe and progressive muscle weakness will develop respiratory failure or pneumonia.  Difficulty swallowing may cause weight loss and malnutrition. 

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research relating to polymyositis in laboratories at the NIH and support additional research through grants to major medical institutions across the country.  Currently funded research is exploring patterns of gene expression among the inflammatory myopathies, the role of viral infection as a precursor to the disorders, and the safety and efficacy of various treatment regimens. 

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Polymyositis in Emergency Medicine  Medscape Reference

 

 

Other possible complications: Congestive heart failure , arrhythmia, interstitial lung disease, pneumonia, dysphagia (difficulty swallowing), arthralgias, symmetric arthritis

Causes:unknown but there are a few theories - autoimmune, viral,  a paraneoplastic syndrome (collections of symptoms that result from substances produced by a tumor)

 

 

 

Polymyositis: Inflammatory infiltrates in a muscle biopsy from

Jensflorian

 

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892


 

 

Organizations

American Autoimmune Related Diseases Association
22100 Gratiot Avenue
Est Detroit, MI   48021-2227
aarda@aarda.org
http://www.aarda.org

Myositis Association
1737 King Street
Suite 600
Alexandria, VA   22314
tma@myositis.org
http://www.myositis.org

Muscular Dystrophy Association
3300 East Sunrise Drive
Tucson, AZ   85718-3208
mda@mdausa.org
http://www.mda.org
National Organization for Rare Disorders (NORD)
P.O. Box 1968
(55 Kenosia Avenue)
Danbury, CT   06813-1968
orphan@rarediseases.org
http://www.rarediseases.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health, DHHS
31 Center Dr., Rm. 4C02 MSC 2350
Bethesda, MD   20892-2350
NIAMSinfo@mail.nih.gov
http://www.niams.nih.gov

National Organization for Rare Disorders (NORD)
P.O. Box 1968
(55 Kenosia Avenue)
Danbury, CT   06813-1968
orphan@rarediseases.org
http://www.rarediseases.org

 

 

 

Related NINDS Publications and Information

Myositis Outcomes Workshop
Health Disparities Working Group Meeting: Cognitive and Emotional Health Myositis Outcomes Workshop

 Mortality in Polymyositis

5-year mortality rate is 20%.

Mortality is related to associated cancer or breathing complications. Patients with cardiac involvement or swallowing problems  have a higher mortality rate.

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