Polymyositis

Polymyositis is a disease of muscle inflammation. Myositis is the general category for inflammatory muscles diseases such as juvenile myositis, dermatomyositis, inclusion body myositis, and polymyositis. Referred to as inflammatory myopathies, the muscle inflammations can cause damage to the muscles. Polymyositis is one of the autoimmune diseases in this group. The predominant age group that appears to be prone to the disease include thirty-five to forty-four and fifty-five to sixty-four year-old men and women. Polymyositis is more common among women, with a statistical ratio of two to one. Children under the age of eighteen are generally not affected by polymyositis. When the inflammatory condition of polymyositis is seen on the skin as well, this is termed dermatomyositis. The disease does not manifest immediately; rather, there is a gradual process of weakness over a three- to six-month period.

Background

Given the autoimmune aspect of the disease, the immune-related white blood cells attack the muscle tissue. The area of the trunk or torso is the main part of the body that is affected. A debilitating weakness can occur. Additionally, the lungs of people with polymyositis can be affected, thus compromising breathing. There is a possibility that muscles of the body further away from the trunk can also become affected by the disease; if this occurs, it may only happen when there is disease progression.

Symptoms. The disease may not be easily identified at first. Patients may present with a period of weakness lasting a few weeks or months. This may start gradually and progress. Joint pain or weakness may be experienced as well as a general feeling of fatigue and exhaustion. Rising off a chair may be challenging as is the movement of raising one's arms to perform a simple action. Climbing stairs or lifting objects may feel extremely difficult or impossible. Likewise, when lying down, a person may find it difficult to get up. The malaise is felt in the torso or core area. Muscles of the hips, thighs, and shoulders may be affected. Muscles may ache, and the body may be sensitive to touch. Dysphagia may occur, with the person finding it difficult to swallow. As the heart and lungs may be involved in the illness, patients may be short of breath. Further symptoms may include fever and weight loss. A skin irritation may be seen, such as a rash around the eyes (red or violet), on the knuckle area of the hand, on elbows, knees, neck, and chest.

Diagnosis. Polymyositis diagnosis occurs via a series of tests. Following a full physical examination by a doctor, the patient will be sent for blood tests. Further testing may be conducted to ascertain the state of the nerves and muscles. These include a nerve conduction test known as electromyography (EMG) and a muscle diagnostic test in the form of magnetic resonance imaging (MRI). A muscle biopsy performed as a minor medical procedure may be required, so that the medical team is able to confirm that the person has polymyositis.

Other instances where polymyositis may be seen include the presence of the disease alongside another. Incidences of certain cancers (breast, colon, lung, lymphoma, ovarian) may also involve polymyositis and dermatomyositis.

Overview

Muscle Inflammation and Damage. The main feature of polymyositis is the inflammation of muscles and the damage to the muscles that ensues. Polymyositis comes with a high level of muscle enzymes identified in blood tests. The inflamed muscles, caused by the disease, release these enzymes into the blood.

Autoimmune Disease. Both polymyositis and dermatomyositis are autoimmune diseases. Poly refers to many, and myositis is broken up into myo, meaning muscle, and itis, meaning inflammation. Autoimmune implies the immune system acting upon itself (auto); in this case the body's own muscle tissues are attacked by the blood cells meant to protect it.

Causes. The cause of polymyositis remains elusive despite constant research. There is a possibility that hereditary factors may be responsible. As research continues and develops into the immune system and related diseases, the hope is that understanding of the immune system and its functioning will facilitate deeper knowledge, and disease causes will become evident. What research has revealed so far is that immune system cells appear to invade muscle tissue at the onset of the disease, continuing to attack the muscles and causing damage.

Medications. Medications for polymyositis may comprise a number of prescriptions. The primary medication consists of immune system suppressants. Corticosteroids are typically prescribed, particularly as the first option to treat the illness. Their effectiveness relates to the ability to reduce muscle inflammation. When corticosteroids are not found to improve the condition, specialists may prescribe immunosuppressive medications. Various medicines of this type include methotrexate, azathioprine, cyclosporine, tacrolimus, chlorambucil, mycophenolate, cyclophosphamide, and rituximab. Intravenous directives are performed when the polymyositis is severe, by giving the patient an infusion of immunoglobulins (IVIG). Because of the muscular effects of the disease, doctors usually recommend a course of physical therapy to accompany the medical treatment.

Lung Issues. Patients with polymyositis experiencing lung issues will consult with a pulmonologist (lung specialist). Medication and treatment will be prescribed accordingly.

Prognosis. There is a good prognosis for people who catch the disease in its early stages. Possibilities of the disease becoming inactive happen often. In these instances the process of rehabilitating the muscles can occur with beneficial results. Exercises to prevent the wasting away of unused muscles will be implemented with the aim of strengthening the affected and surrounding muscles.

Helpful Organizations. In the United States, there are a number of organizations or associations providing information or support regarding muscle diseases such as polymyositis. These include: Muscular Dystrophy Association, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Information Clearinghouse, National Institutes of Health, Myositis Association, and National Organization for Rare Disorders. Concerned patients or members of the public are always advised to consult with their doctors in addition to seeking medical information via public resources. Personal medical history is taken into account by a person's private doctor, physician, or specialist.

Bibliography

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"Polymyositis (PM)." MDA For Strength, Independence & Life. Muscular Dystrophy Association, Inc., 2016. Web. 1 May 2016.

"NINDS Polymyositis Information Page." National Institute of Neurological Disorders and Stroke. National Institute of Neurological Disorders and Stroke, 2015. Web. 1 May 2016.

"Polymyositis – Adult." New York Times. Health Guide. The New York Times Company, 22 March 2013. Web. 1 May 2016.

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