Polymyositis
| Classification according to ICD-10 | |
|---|---|
| M33.2 | Polymyositis |
| ICD-10 online (WHO version 2019) | |
The polymyositis is a systemic inflammatory disease of the skeletal muscles with a perivascular lymphocytic infiltration. It is assigned to the collagenoses . The cause ( etiology ) is unknown. If the skin is involved, it is called dermatomyositis .
to form
There are five types of polymyositis:
| shape | frequency | |
| Group 1 | primary idiopathic polymyositis | 33% of the cases |
| Group 2 | primary idiopathic dermatomyositis | 33% |
| Group 3 |
Paraneoplastic poly- or dermatomyositis: concomitant disease in tumors of the lungs, ovaries, breasts, gastrointestinal tract and myeloproliferative diseases |
8th % |
| Group 4 | child dermatomyositis with accompanying vasculitis | 5-10% |
| Group 5 | Myositis overlap syndromes in collagenoses | 20% |
Particularly in older patients, dermato- or polymyositis is often paraneoplastic in origin, whereby the symptoms of dermatomyositis can precede the occurrence of a diagnostically verifiable tumor disease.
Symptoms
- Muscle weakness
- aching
- unspecific signs of inflammation ( CRP , fever , sedimentation reaction )
- Arthralgia
- possibly Raynaud's syndrome
- possibly swallowing disorders u. Involvement of internal organs
In the case of dermatomyositis, the following skin symptoms can be seen:
- purple rash over the eyelids , bridge of the nose and cheeks
- periorbital edema
- local erythema
- scaly eczematous dermatitis .
Laboratory diagnostics show increased muscle enzyme levels. The detection of autoantibodies is possible, e.g. B. Anti-Jo1 Antibodies .
forecast
The mortality is increased by a factor of 4th The most common causes of death are heart and lung diseases.
Half of those affected can discontinue corticosteroid therapy after five years and achieve complete healing, which may leave muscle weakness. In 30% the disease comes to a standstill. About 20% suffer from deterioration despite therapy.
Particularly in older patients, dermato- or polymyositis is often paraneoplastic in origin, whereby the symptoms of dermatomyositis can precede the occurrence of a diagnostically verifiable tumor disease.
therapy
The disease requires physical rest. Corticosteroids ( prednisone ) are used as the therapeutic agent of choice . Immunosuppressants and immunoglobulins can also be administered.
Long-term physiotherapy should be aimed for.
