Sree Chitra Tirunal Institute for Medical sciences and Technology ...

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IBM PM DMAge at onset >50 adults All agesSex M F FFamily history Rare No NoAss.with No slight yesmalignancyConnective tissue 15% yes yesdisorderWeakness P=D P>D P>DRash No No YesCPK 10 50 times 50 timesResponse to Rx poor variable GoodBiopsy Rimmed vacuoles EM inflammation PV inflammation'Amyloid deposits Muscle fiber invasion Complement depositsTubulofilaments CD8+ T cells .CD4+ and B cellsTable II: Comparison of major types of inflammatory muscle diseaseTen important points to ponder1. Pain and discomfort are rarely prominent in myositis2. The normal upper limit for serum creatine kinase is higher than we usually think3. Failure io appreciate points 1 and 2 leads to many patients being wronglydiagnosed, and treated, as having polymyositis4. Pure polymyositis is a rare condition5. Inflammatory infiltrates in a muscle biopsy may be a secondary phenomenon andfailure to appreciate this is a common reason for wrong diagnosis andinappropriate treatment6. Absence of inflammatory infiltrates in a biopsy does not exclude myositis7. Despite their clinical similarities, dermatomyositis and polymyositis arefundamentally different disorders in terms of pathogenesis8. Inclusion body myositis, the most common acquired myopathy over the age of 50years, is frequently misdiagnosed as polymyositis. Whether it is a true "myositis"remains hotly debated ,9. Dermatomyositis may be a paraneoplastic disorder, particularly in the elderly10. Long term morbidity and mortality relate to interstitial lung disease, myocardialinvolvement, and associated malignancy19
AIMS AND OBJECTIVES OF THE STUDY1. To study the clinical, electrophysilogical & histopathlogicalprofile and their correlations in inflammatory muscle disease2. To study the overall response rate to treatment and relapse ratewith drug tapering3. To assess the predictive factors which can determine the overalloutcome20
Page 1 and 2: Sree Chitra Tirunal Institute forMe
Page 3 and 4: PROJECT REPORTCLINICAL, ELECTOPHYSI
Page 5 and 6: CONTENTS1. INTRODUCTION2. REVIEW OF
Page 7 and 8: • IdiopathicClassification of the
Page 9 and 10: CLINICAL FEATURESMany inherited myo
Page 11 and 12: PolymyositisEvolution of weakness i
Page 13 and 14: The rate of progression is typicall
Page 15 and 16: Muscle biopsyPathological feature D
Page 17 and 18: controlled trial. These have includ
Page 19 and 20: AGE DISTRIBUTION• < 18yrs|»18-50
Page 21 and 22: Deep tendon reflexes2 40S 30° 201
Page 23 and 24: EMG• Myopathic• Neurogenic• N
Page 25: Picturel9: Light microscopy: Histop
Page 29 and 30: Diagnostic Criteria for Inclusion B
Page 31 and 32: L ower r 1m b prox1m . al we akn es
Page 33 and 34: Final diagnosis:DiagnosisFrequencie
Page 35 and 36: Prognostic factors: There was no st
Page 37 and 38: cases. Other common symptoms includ
Page 39 and 40: 5 (17%) liM with neoplasia (lymphom
Page 41 and 42: Follow up:Mean follow up period was
Page 43 and 44: REFERENCESl.Amato AA et al. Inclusi
Page 45 and 46: Clinical, electrophysiological and
Page 47 and 48: 5.4 Not treated6.0Follow-up: 3 mont
Page 49 and 50: 1 0.6 ESR.1. Improved 2 .stationary

Sree Chitra Tirunal Institute for Medical sciences and Technology ...

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