Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1992 Jan;51(1):41–44. doi: 10.1136/ard.51.1.41

Idiopathic myositis: a rheumatological view.

M R Ehrenstein 1, M L Snaith 1, D A Isenberg 1
PMCID: PMC1004616  PMID: 1540036

Abstract

Twenty five patients with idiopathic myositis attended this department for long term follow up from 1980 to 1989. Twelve patients had primary polymyositis (four men, eight women) and six had primary dermatomyositis (three men, three women); five women had an overlap syndrome. Two patients had a malignant condition associated with the myositis. The mean age at diagnosis was 40 years. All of the patients had proximal muscle weakness, 18/25 had a raised creatine kinase value (mean 2325 IU/l), 19/20 had an abnormal electromyogram, and 19/24 had positive muscle biopsy samples. Of the disease specific antibodies, anti-Jo-1 was detected in only 1/21 patients tested (three patients with fibrosing alveolitis were negative for this antibody), but the 56 kDa antibody was detected in 12/17 patients. The HLA data analysed in the white patients (17/25) showed that 6/8 of those tested were HLA-DR3 positive. All patients were treated with prednisolone and azathioprine was used for 14/25 patients. Only three deaths occurred during the eight year follow up, but there was a substantial morbidity, which may reflect the referral pattern. Muscle strength tests and creatine kinase levels were useful in recording the response to treatment in some patients. These data emphasise that careful long term follow up of patients with myositis is mandatory and that although the present treatment strategy has substantially reduced the death rate, morbidity associated with the disease remains a major problem.

Full text

PDF
41

Images in this article

41Image
on p.41

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arad-Dann H., Isenberg D. A., Shoenfeld Y., Offen D., Sperling J., Sperling R. Autoantibodies against a specific nuclear RNP protein in sera of patients with autoimmune rheumatic diseases associated with myositis. J Immunol. 1987 Apr 15;138(8):2463–2468. [PubMed] [Google Scholar]
  2. Arad-Dann H., Isenberg D., Ovadia E., Shoenfeld Y., Sperling J., Sperling R. Autoantibodies against a nuclear 56 kDa protein: a marker for inflammatory muscle disease. J Autoimmun. 1989 Dec;2(6):877–888. doi: 10.1016/0896-8411(89)90014-0. [DOI] [PubMed] [Google Scholar]
  3. Bohan A., Peter J. B., Bowman R. L., Pearson C. M. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 1977 Jul;56(4):255–286. doi: 10.1097/00005792-197707000-00001. [DOI] [PubMed] [Google Scholar]
  4. Bohan A., Peter J. B. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975 Feb 13;292(7):344–347. doi: 10.1056/NEJM197502132920706. [DOI] [PubMed] [Google Scholar]
  5. Bunch T. W. Prednisone and azathioprine for polymyositis: long-term followup. Arthritis Rheum. 1981 Jan;24(1):45–48. doi: 10.1002/art.1780240107. [DOI] [PubMed] [Google Scholar]
  6. Bunch T. W., Worthington J. W., Combs J. J., Ilstrup D. M., Engel A. G. Azathioprine with prednisone for polymyositis. A controlled, clinical trial. Ann Intern Med. 1980 Mar;92(3):365–369. doi: 10.7326/0003-4819-92-3-365. [DOI] [PubMed] [Google Scholar]
  7. DeVere R., Bradley W. G. Polymyositis: its presentation, morbidity and mortality. Brain. 1975 Dec;98(4):637–666. doi: 10.1093/brain/98.4.637. [DOI] [PubMed] [Google Scholar]
  8. Glynn L. E. Inflammatory disorders of muscle. Histopathology. Clin Rheum Dis. 1984 Apr;10(1):53–73. [PubMed] [Google Scholar]
  9. Hirsch T. J., Enlow R. W., Bias W. B., Arnett F. C. HLA-D related (DR) antigens in various kinds of myositis. Hum Immunol. 1981 Oct;3(2):181–186. doi: 10.1016/0198-8859(81)90055-0. [DOI] [PubMed] [Google Scholar]
  10. Hochberg M. C., Feldman D., Stevens M. B. Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. Semin Arthritis Rheum. 1986 Feb;15(3):168–178. doi: 10.1016/0049-0172(86)90014-4. [DOI] [PubMed] [Google Scholar]
  11. Isenberg D. A., Rowe D., Tookman A., Hopp A., Griffiths M., Paice E., Stewart J., Beverley P. C. An immunohistological study of secondary Sjögren's syndrome. Ann Rheum Dis. 1984 Jun;43(3):470–476. doi: 10.1136/ard.43.3.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Leirisalo-Repo M., Suoranta H. Ten-year follow-up study of patients with Yersinia arthritis. Arthritis Rheum. 1988 Apr;31(4):533–537. doi: 10.1002/art.1780310410. [DOI] [PubMed] [Google Scholar]
  13. Medsger T. A., Jr, Dawson W. N., Jr, Masi A. T. The epidemiology of polymyositis. Am J Med. 1970 Jun;48(6):715–723. doi: 10.1016/s0002-9343(70)80006-7. [DOI] [PubMed] [Google Scholar]
  14. Morton B. D., 3rd, Statland B. E. Serum enzyme alterations in polymyositis. Possible pitfalls in diagnosis. Am J Clin Pathol. 1980 Apr;73(4):556–557. doi: 10.1093/ajcp/73.4.556. [DOI] [PubMed] [Google Scholar]
  15. Nishikai M., Reichlin M. Heterogeneity of precipitating antibodies in polymyositis and dermatomyositis. Characterization of the Jo-1 antibody system. Arthritis Rheum. 1980 Aug;23(8):881–888. doi: 10.1002/art.1780230802. [DOI] [PubMed] [Google Scholar]
  16. Ogle S. Retrospective study of polymyositis in Auckland over 10 years. N Z Med J. 1980 Dec 10;92(673):433–435. [PubMed] [Google Scholar]
  17. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  18. Yoshida S., Akizuki M., Mimori T., Yamagata H., Inada S., Homma M. The precipitating antibody to an acidic nuclear protein antigen, the Jo-1, in connective tissue diseases. A marker for a subset of polymyositis with interstitial pulmonary fibrosis. Arthritis Rheum. 1983 May;26(5):604–611. doi: 10.1002/art.1780260505. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES