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. 1989 Jun;82(6):333–338. doi: 10.1177/014107688908200607

Clinical, biochemical and histological responses to treatment in polymyositis: a prospective study.

R J Lane 1, A Emslie-Smith 1, I E Mosquera 1, P Hudgson 1
PMCID: PMC1292163  PMID: 2810311

Abstract

Routine methods of monitoring treatment responses in polymyositis patients, such as clinical strength assessments and measurements of ESR and serum creatine kinase, have been compared with functional strength measurements and assay of serum myoglobin levels, in a prospective study of nine cases followed for up to five years. Seven patients also underwent serial muscle biopsies during the first year of treatment in order to document the nature and chronology of histological changes during therapy. Inflammatory and necrobiotic changes indicating active myositis resolved within six months in all cases and no patient developed histological evidence of steroid myopathy. Scores on functional muscle strength assessments improved more slowly than static manual muscle strength test results, reflecting morphometric and architectural abnormalities in the biopsies which persisted throughout the period of observation. Serum creatine kinase levels returned to normal more rapidly than serum myoglobin. No statistical relationship was found between muscle strength measurements and biochemical or histological changes within the patients as a group, but variations in these indices in individual subjects reflected changes in clinical state.

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Selected References

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

  1. Askmark H., Osterman P. O., Roxin L. E., Venge P. Radioimmunoassay of serum myoglobin in neuromuscular diseases. J Neurol Neurosurg Psychiatry. 1981 Jan;44(1):68–72. doi: 10.1136/jnnp.44.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bombardieri S., Clerico A., Riente L., Del Chicca M. G., Vitali C. Circadian variations of serum myoglobin levels in normal subjects and patients with polymyositis. Arthritis Rheum. 1982 Dec;25(12):1419–1424. doi: 10.1002/art.1780251205. [DOI] [PubMed] [Google Scholar]
  3. Brooke M. H., Engel W. K. The histographic analysis of human muscle biopsies with regard to fiber types. 2. Diseases of the upper and lower motor neuron. Neurology. 1969 Apr;19(4):378–393. doi: 10.1212/wnl.19.4.378. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Csuka M., McCarty D. J. Simple method for measurement of lower extremity muscle strength. Am J Med. 1985 Jan;78(1):77–81. doi: 10.1016/0002-9343(85)90465-6. [DOI] [PubMed] [Google Scholar]
  6. 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]
  7. Edwards R. H., Wiles C. M., Round J. M., Jackson M. J., Young A. Muscle breakdown and repair in polymyositis: a case study. Muscle Nerve. 1979 May-Jun;2(3):223–228. doi: 10.1002/mus.880020311. [DOI] [PubMed] [Google Scholar]
  8. Henriksson K. G. Recent advances in investigation of polymyositis. Acta Neurol Scand Suppl. 1980;78:60–67. doi: 10.1111/j.1600-0404.1980.tb05426.x. [DOI] [PubMed] [Google Scholar]
  9. Henriksson K. G., Sandstedt P. Polymyositis--treatment and prognosis. A study of 107 patients. Acta Neurol Scand. 1982 Apr;65(4):280–300. doi: 10.1111/j.1600-0404.1982.tb03087.x. [DOI] [PubMed] [Google Scholar]
  10. Lane R. J., Maskrey P., Nicholson G. A., Siddiqui P. Q., Nicholson M., Gascoigne P., Pennington R. J., Gardner-Medwin D., Walton J. N. An evaluation of some carrier detection techniques in Duchenne muscular dystrophy. J Neurol Sci. 1979 Nov;43(3):377–394. doi: 10.1016/0022-510x(79)90017-0. [DOI] [PubMed] [Google Scholar]
  11. Mastaglia F. L., Ojeda V. J. Inflammatory myopathies: Part 2. Ann Neurol. 1985 Apr;17(4):317–323. doi: 10.1002/ana.410170402. [DOI] [PubMed] [Google Scholar]
  12. Nicholson L. V. Serum myoglobin in muscular dystrophy and carrier detection. J Neurol Sci. 1981 Sep;51(3):411–426. doi: 10.1016/0022-510x(81)90118-0. [DOI] [PubMed] [Google Scholar]
  13. Nishikai M., Homma M. Circulating autoantibody against human myoglobin in polymyositis. JAMA. 1977 Apr 25;237(17):1842–1844. [PubMed] [Google Scholar]
  14. PEARCE J. M., PENNINGTON R. J., WALTON J. N. SERUM ENZYME STUDIES IN MUSCLE DISEASE. I. VARIATIONS IN SERUM CREATINE KINASE ACTIVITY IN NORMAL INDIVIDUALS. J Neurol Neurosurg Psychiatry. 1964 Feb;27:1–4. doi: 10.1136/jnnp.27.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Poston R. N. Basic proteins bind immunoglobulin G: a mechanism for demyelinating disease? Lancet. 1984 Jun 9;1(8389):1268–1271. doi: 10.1016/s0140-6736(84)92448-6. [DOI] [PubMed] [Google Scholar]
  16. Resnick J. S., Mammel M., Mundale M. O., Kottke F. J. Muscular strength as an index of response to therapy in childhood dermatomyositis. Arch Phys Med Rehabil. 1981 Jan;62(1):12–19. [PubMed] [Google Scholar]
  17. Schwarz H. A., Slavin G., Ward P., Ansell B. M. Muscle biopsy in polymyositis and dermatomyositis: a clinicopathological study. Ann Rheum Dis. 1980 Oct;39(5):500–507. doi: 10.1136/ard.39.5.500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Wada K., Ueno S., Hazama T., Ogasahara S., Kang J., Takahashi M., Tarui S. Radioimmunoassay for antibodies to human skeletal muscle myosin in serum from patients with polymyositis. Clin Exp Immunol. 1983 May;52(2):297–304. [PMC free article] [PubMed] [Google Scholar]

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