Myositis
| Classification according to ICD-10 | |
|---|---|
| M60 | Myositis |
| M63 | Muscle Diseases in Diseases Classified Elsewhere |
| M33.2 | Polymyositis |
| ICD-10 online (WHO version 2019) | |
As myositis refers to a inflammatory disease of skeletal muscle . Myositides can be hereditary, caused by infections ( viruses , bacteria , parasites ), by disorders of the immune system ( allergies , autoimmune diseases , HIV infections ) and by toxic substances. Muscles can be confronted with the triggering factors via the blood vessel system or through injury (stab wounds , deep flesh wounds).
Occasionally, especially with myositis caused by trauma , local metaplasia with a deposit of calcium salts can occur (muscle ossification , myositis ossificans ). Such ossification can also occur in paraplegia ( paraosteoarthropathy ).
Forms of myositis
Myositis can be divided into different groups. A distinction must firstly the hereditary myositis, including the Münchmeyer syndrome counts, viral myositis with Pleurodynia epidemic (Bornholm disease), bacterial myositis, including leprosy , syphilis , tetanus , Mycoplasma pneumoniae infection and pyomyositis count, then the parasitic myositis shapes with sarcocystosis , schistosomiasis , trichinosis and cysticercosis ( tapeworm - finnen ), finally autoimmune diseases - to belong polymyositis , dermatomyositis , inclusion body myositis , interstitial myositis (actually a vasculitis ) and masticatory muscle myositis (with domestic dogs ) - to continue the toxic myositis with the cross crate (horse disease).
Diagnosis
Diagnosing myositis is not easy and requires some differential diagnostic considerations. The main pillars of a diagnosis are clinical symptoms, measurement of muscle enzyme serum concentrations, electromyography and muscle biopsy.
Serum concentrations of various enzymes that are released when muscle fibers are damaged or destroyed, and other muscle-specific values make it possible to assess the current status. These include the muscle enzymes of creatine kinase (CK-Mi, CK-B, CK-M, CK-MB), lactate dehydrogenase aldolase and glutamate oxaloacetate transferase (SGOT) and myoglobin
In some patients, there are also elevated levels of myositis-specific antibodies, but with unexplained pathophysiological relevance, which are also often associated with other diseases. For example, antisynthetic antibodies (Jo-1, Pl-7, Pl-12, OJ, EJ) can indicate myositis, fibrosing alveolitis, or arthritis. Anti-SRP, Anti-Mi-2, Anti-PmScl, Anti-U1-RNP and Anti-Ku are also indicators of myositis, but also of other diseases.
Due to the lack of specificity of the examination methods mentioned above, a muscle biopsy is the most important decision criterion. The choice of the right location for the biopsy is evident, which often requires imaging measures in advance, often magnetic resonance imaging . A subsequent pathological examination can then for the first time reliably differentiate between the individual myositis forms.
See also
literature
- S2k guidelines for myositis syndromes (Heinz Windl) of the German Society for Neurology. In: AWMF online (as of 2014)
- Verena Lehmann: Humoral immunoreactivities against muscle cell membrane proteins in inflammatory myositis (dissertation to obtain the academic degree Doctor medicinae), Medical Faculty Charité, Berlin
Web links
Individual evidence
- ^ EM Fabricius, I. Hoegl, W. Pfaeffl: Ocular myositis as first presenting symptom of human immunodeficiency virus (HIV-1) infection and its response to high-dose cortisone treatment . In: Br J Ophthalmol. tape 75 , no. 11 , p. 696-697 .
- ↑ a b Entry on myositis in Flexikon , a wiki from DocCheck , accessed on May 2, 2015.
- ↑ Volker Schumpelick, Niels Bleese, Ulrich Mommsen and others: Short textbook on surgery. 8th edition. Georg Thieme Verlag, Stuttgart / New York 2010, ISBN 978-3-13-127128-0 , p. 723.
- ↑ Nuns maker: muscle inflammation (myositis)
- ↑ Entry on Bornholm's disease in Flexikon , a wiki from DocCheck , accessed on November 26, 2015.
- ↑ Benedikt Schoser: Inflammatory Muscle Diseases. German Society for Muscle Diseases e. V., as of January 2015 ( page no longer available , search in web archives: dgm.org )
- ↑ Carsten Schröter: Myositis - A Brief Introduction.
- ^ M. Eickhoff: Masticatory muscle myositis.
- ↑ Cross crate (stress myopathy, holiday sickness) in horses
- ↑ a b myositis . Friedrich Baur Institute; accessed on May 2, 2015.
- ^ Creatine kinase (CK) . medicoconsult.de; accessed on May 2, 2015.
- ↑ enzyme pattern . In: Lexicon. Spectrum - Akademischer Verlag, Heidelberg 1999; accessed on May 2, 2015.
- ^ A b E. Genth: Diagnostic criteria for idiopathic myositis. ( dgrh.de ( memento of April 17, 2016 in the Internet Archive ) accessed on May 2, 2015).
- ^ A. Bornemann, S. Heitmann, A. Lindner: Myositiden. In: Pathologist. Volume 30, No. 5, 2009, pp. 352-356. doi: 10.1007 / s00292-009-1167-7 . (neuromuskulaeres-referenzzentrum.dgnn.rwth-aachen.de ; PDF; accessed on May 2, 2015)
