Myositis is an inflammatory disease of the muscles. It can be caused by a variety of conditions, including autoimmune diseases, infections, and toxins. It is characterized by muscle weakness and pain. Symptoms can range from mild to severe, depending on the type and severity of the condition. Treatment typically involves medications and physical therapy. myositis disease
What are the Mayopsthies
Inflammatory myopathies are a group of diseases that involve chronic (long-term) muscle inflammation, muscle weakness, and, in some cases, muscle pain. Myopathy is a general medical term used to describe a number of conditions affecting the muscles. All myopathies cause muscle weakness.
There are four main types of chronic, or long-term, inflammatory myopathies:
- Polymyositis
- Dermatomyositis
- Inclusion body myositis
- necrotizing autoimmune myopathy
What are the causes of these disorders?
Myositis, or generalized muscle inflammation, can be caused by:
An autoimmune disorder in which the immune system attacks the muscles
Allergic reaction after exposure to a toxin or drug
A virus or other infectious organisms such as bacteria or fungi
Although the cause of many inflammatory myopathies is unknown, the majority are thought to be autoimmune disorders, in which the body’s immune response system, which normally defends against infection and disease, attacks its own muscle fibers, blood Invades blood vessels, connective tissue, organs or joints.
Signs And Symptoms?
Common symptoms of chronic inflammatory pathology embody slow however progressive muscle weakness. Inflammation damages muscle fibers, resulting in weakness, and may have an effect on the arteries and blood vessels that run through the muscles. alternative symptoms embody fatigue when walking or standing, frequent episodes of tripping or falling, and issue swallowing or respiratory. Some individuals could have muscle aches or muscle pains that ar tender to the bit.
Polymyositis
Polymyositis affects skeletal muscles (the sort concerned with body movement) on each side of the body. it’s seldom see in individuals under the age of twenty. Usually, it starts between the ages of thirty and sixty.
The signs and symptoms of myositis vary greatly from person to person, which might create it troublesome to diagnose. Untreated progressive muscle weakness will cause issue swallowing, speaking, rising from a sitting position, rising stairs, lifting objects, or reaching overhead. Some individuals with myositis can even develop inflammatory disease, respiratory issues, heart arrhythmias (irregular heartbeats), or heart disease (when the guts is unable to pump enough oxygen-rich blood).
Dermatomyositis
Dermatomyositis could be a roseola that precedes or accompanies progressive muscle weakness. The rash seems uneven with a purple or red hue and generally seems on the eyelids and on the muscles wont to extend or straighten joints, as well as fingers, elbows, knees, and toes. Red spots can even seem on the face, neck, shoulders, higher chest, back and alternative places. Swelling could occur within the affected areas. The rash is usually not obvious muscle involvement and sometimes becomes a lot of pronounced in daylight
Adults with myositis
Adults with myositis could expertise weight loss or an inferior fever, swelling of the lungs, and sensitivity to lightweight. Adult myositis, in contrast to myositis, will occur with breast, lung, feminine sex organs,s or viscus tumors. kids and adults with myositis could develop atomic number 20 deposits, that seem like exhausting patches underneath the skin or within the muscles (called calcinosis). Calcinosis sometimes happens one to 3 years when the onset of the unwellness however could occur many years later. These deposits are see a lot of oftentimes in childhood-onset myositis than in adolescent-onset myositis.
myositis and myositis
In some cases of myositis and myositis, distal muscles, those aloof from the middle of the body, like within the arms and around the ankles and wrists), could become affected because the unwellness progresses. myositis and myositis could also be related to albuminoid vascular or response diseases like lupus. myositis can even be related to infectious diseases like HIV, which causes AIDS.
Inclusion body inflammation (IBM) is the most typical sort of inflammatory pathology in individuals fifty years age or older and is characterize by slow, progressive muscle weakness and wasting over months or years. IBM affects each proximal and distal muscle, sometimes within the thighs and arms, and it usually happens on each side of the body, though muscle weakness could have an effect on just one aspect of the body. It conjointly options muscle degeneration with multiprotein aggregates (clumps) in the muscle which will contain toxins found in Alzheimer’s disease and alternative neurodegenerative diseases.
primary noticeable symptoms
Falls and slips are sometimes the primary noticeable symptoms. The disorder usually begins with weakness within the wrists and fingers, inflicting issues in pinching, buttoning, and holding objects. individuals could expertise weakness within their carpus and finger muscles and atrophy (thinning or loss of enormous muscle mass) within the arm muscles and musculus quadriceps femoris muscles in the thighs. issue swallowing happens in regarding 1/2 IBM cases because of involvement of the muscles of the throat.
Symptoms of the unwellness sometimes begin when age fifty, though the unwellness will occur earlier. in contrast to myositis and myositis, IBM is a lot of common in men than in ladies.
Necrotizing response pathology (NAM)
Necrotizing response pathology (NAM) could be a rare and comparatively freshly recognized subgroup of inflammatory myopathies. NAM will occur at any age however most typically affects adults. Symptoms are just like those of myositis and myositis, with weakness in each of the higher and lower body, issues obtaining up from low chairs, rise stairs, or lifting objects. However, the onset of those symptoms is often a lot of severe and sudden, peaking over days or weeks. alternative symptoms embody fatigue, weight loss, and muscle aches.
NAM happens alone or when a virus infection, with cancer, in animal tissue disorders like scleroderma, or rarely, in individuals taking cholesterol-lowering medicine. Muscle weakness and pain could worsen even when individuals stop taking the drug.
They usually affect children between the ages of 2 and 15. Symptoms include weakness and inflammation of nearby muscles, edema (an abnormal accumulation of fluid within body tissues that causes swelling), muscle pain, fatigue, skin rash, abdominal pain, fever, and cramps. As a result of the shortening of the muscles or tendons around the joint, the muscle is cause by inflammation in the tendon, and prevents the joint from moving freely.
The heart can also be affect. Between 20 and 40 percent of children with juvenile dermatomyositis develop calcinosis, which can cause significant muscle weakness and pain, joint stiffness, skin ulcers, and loss of muscle mass.
How are inflammatory myopathies diagnosed?
How are inflammatory myopathies diagnose?
Diagnosis is based on medical history, physical examination findings including muscle strength tests, and blood samples that show elevated levels of various muscle enzymes and autoantibodies. Diagnostic tools include:
Electromyography to record the electrical activity generated by muscles during contraction and relaxation
Ultrasound to look for muscle inflammation
Magnetic resonance imaging to reveal abnormal muscle anatomy.
A biopsy specimen of muscle tissue should be examine for chronic inflammation, muscle fiber death, vascular malformation, or other changes specific to the diagnosis of a particular type of inflammatory myopathy. A skin biopsy may show skin changes associated with dermatomyositis.
How are these disorders treated?
Chronic inflammatory myopathies cannot be cure in most adults, but many of the symptoms can be treat. Options include:
Treatment
Physical therapy
exercise
Heat therapy
Orthotics and assistive devices
rest
Dermatomyositis, polymyositis, and necrotizing autoimmune myopathy are treat first with high doses of corticosteroid medications, such as prednisone. It is often give as an oral medication but can also be give intravenously.
Immunosuppressant drugs, such as azathioprine and methotrexate, can reduce inflammation in individuals who do not respond well to prednisone. Intermittent treatment using intravenous immunoglobulin may increase the chance of recovery in individuals with dermatomyositis, polymyositis or NAM. Other immunosuppressive agents that can treat the inflammation associated with dermatomyositis and polymyositis include cyclosporine A. Cyclophosphamide, mycophenolate mofetil, and tacrolimus.
Adrenocorticotropic hormone gel injections may be another option for people who do not respond to or cannot tolerate other drug treatment options. Biological treatments such as rituximab or tumor necrosis factor (TNF) inhibitors. Such as infliximab or etanercept may be use in severe cases where other treatment options have fail. However, there are very few studies that have shown how well these agents treat polymyositis and dermatomyositis.
Physical therapy is usually recommend to prevent muscle atrophy as well as maintain muscle strength and range of motion. Prolong bed rest should be avoided, as people may develop muscle spasms, decrease muscle function, and joint stiffness. A low-sodium diet can help reduce edema (swelling) and cardiovascular (heart and blood vessel) complications.
Many people with dermatomyositis may need topical ointments such as corticosteroids, tacrolimus, or pimecrolimus for their skin disorders. They should wear a high-protection sunscreen and protective clothing, especially those who are light-sensitive. In rare cases, surgery may be need to remove calcium deposits that cause nerve pain and recurrent infections.
There is no standard, evidence-based course of treatment for inclusion body myositis. The disease is usually unresponsive to corticosteroids and immunosuppressive drugs. Some evidence suggests that immunosuppressive drugs or intravenous immunoglobulin may have a modest, but short-lasting, beneficial effect in rare cases. Physical therapy can help maintain mobility. Other therapy is symptomatic and supportive.
What is the prognosis for these diseases?
In most cases, the symptoms of dermatomyositis resolve with therapy. The disease is usually more severe and resistant to treatment in people with heart problems. About one-third of people with juvenile-onset dermatomyositis recover from their disease, one-third have a relapsing course of the disease, and another third have a more chronic course of the disease.
The diagnosis of polymyositis varies. Most people respond quite well to treatment, but some people with more severe disease do not. These individuals may have significant disabilities. Because polymyositis can cause difficulty swallowing, people can become malnourished. They also increase the risk of falls, which can lead to broken hips and other bones, disability or death. In rare cases, people with severe and progressive muscle weakness may develop respiratory failure or pneumonia.
Although necrotizing autoimmune myopathy is more difficult to treat than polymyositis and dermatomyositis, it usually responds well to long-term combination immunosuppressive therapy.
IBM is generally resistant to all treatments and currently available treatments do little to slow its progression.
What research is being done?
The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to gain fundamental knowledge about the brain and nervous system and to use this knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health, the largest supporter of biomedical research in the world.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is the primary funding institute for myositis and inflammatory myopathies.
A challenge in treating inflammatory myopathies is that, for some individuals, there is little direct correlation between muscle inflammation and the degree of weakness and disability. Although inflammation can be slow or reverse , muscle weakness may not respond to treatment. NIH researchers are working to identify the causes of muscle weakness in order to discover effective treatments. In addition, researchers are working to develop an objective, imaging-based methods that can describe the muscle damage associated with inflammatory muscle disease.
Additionally, NIH-funded researchers are studying childhood-onset polymyositis and dermatomyositis to learn more about their causes, immune system changes during the disease, and related clinical issues. can For example, scientists are studying the role of genetics in the development of juvenile dermatomyositis. Researchers are examining genetic differences between sets of twins to identify links between genes and dermatomyositis that could lead to potential new treatments for the condition.
Currently, there are no treatments approve by the US Food and Drug Administration for the diagnosis of inflammatory myopathies. NIH-funded researchers are looking for better, less invasive ways to diagnose these disorders. For example, researchers are developing a non-invasive test that diagnoses IBM using circulating RNA molecules in blood or urine. Researchers hope the test will help clinicians identify people with IBM and help monitor their response to clinical treatment trials.
Scientists are testing whether sodium thiosulfate can treat the calcium deposits seen in teenagers and adults with dermatomyositis. Other NIH-funded researchers are studying disease susceptibility of genetic diversity in inflammatory myopathies. Researchers at the National Institute of Environmental Health Sciences (NIEHS) are examining possible contributing causes, including dietary supplements, tobacco smoke, and infectious agents. Other researchers are also investigating the effects of certain drugs on muscle inflammation. For example, NIH researchers are exploring the effects of statins on autoimmune muscle disease.
More information about research on myositis and inflammatory myopathies support by NINDS and other NIH institutes and centers can be find using NIH Reporter, a searchable database of current and past research projects supported by NIH and other federal agencies. can The Reporter also includes links to publications and resources on these projects?