A study on demographic pattern of idiopathic inflammatory myopathies in a tertiary care hospital

Authors

  • Srujith C. H. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Kavitha Mohanasundaram Department of Rheumatology, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Jagadeesan M. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Halleys Kumar E. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Kannan R. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Sivasubramanian K. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India
  • Magesh Kumar S. Department of General Medicine, Saveetha Medical College Hospital, SIMATS, Chennai, Tamilnadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20190543

Keywords:

Dermatomyositis, Inclusion body myositis, IIM, Myositis, Proximal weakness, Polymyositis

Abstract

Background: Idiopathic inflammatory myopathies (IIMs) are a group of chronic systemic autoimmune diseases characterized by proximal muscle weakness and elevated muscle enzymes. Aim and Objective was to analyze the demographic profile of patients with idiopathic inflammatory myopathies (IIM).

Methods: This was a cross sectional observational study conducted over a period of two years (2016-2018). After obtaining institutional ethical committee clearance, informed consent from patients. 16 patients who fulfilled the criteria were included in the study. The demographic and the clinical data were analysed.

Results: The mean age was 47.3±11.2 years. The study showed female predominance. ANA was positive in 11(68.7%) patients. Among the 16 patients, 5 (31.25%) had polymyositis and 11 (68.7%) had dermatomyositis. The median enzymes levels were creatinine kinase 1134 U/L, lactic dehydrogenase 477U/L, ALT (alanine aminotransferase) 154 IU/L, AST (aspartate aminotransferase) 236IU/L. Raynaud's phenomenon was seen in 37.5%. In our study, 31.25% had hypothyroidism and 6.25% had diabetic mellitus. On follow up 37.5% developed interstitial lung disease (ILD) and 18.75% were found to have malignancy.

Conclusions: Steroids and immunomodulators are the mainstay of treatment in patients with idiopathic inflammatory myositis. All our patients improved with steroids. It is important to evaluate these patients during early stages and follow up to prevent complications.

References

Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344-7.

Stertz G. Polymyositis. 5 Vol. Berliner Klinische Wochenschrift; 1916:489.

Zantos D, Zhang YU, Felson D. The overall and temporal association of cancer with polymyositis and dermatomyositis. J Rheumatol. 1994;21(10):1855-9.

McGrath ER, Doughty CT, Amato AA. Autoimmune Myopathies: Updates on evaluation and treatment. Neurotherapeutics. 2018 Oct 1:1-9.

Ramesha KN, Kuruvilla A, Sarma PS, Radhakrishnan VV. Clinical, electrophysiologic, and histopathologic profile, and outcome in idiopathic inflammatory myositis: An analysis of 68 cases. Ann Indian Acad Neurol. 2010;13:250-6.

Malik A, Hayat G, Kalia JS and Guzman MA. Idiopathic inflammatory myopathies: clinical approach and management. Front Neurol. 2016;7:64.

Mugii N, Hasegawa M, Matsushita T, Hamaguchi Y, Oohata S, Okita H, et al. Oropharyngeal dysphagia in dermatomyositis: associations with clinical and laboratory features including autoantibodies. PloS one. 2016 May 11;11(5):e0154746.

Clark KEN, Isenberg DA. A review of inflammatory idiopathic myopathy focusing on polymyositis. Eur J Neurol. 2018;25:13-23.

Gamsky TE, Chan MK. Coexistent dermatomyositis and autoimmune thyroiditis. Western J Med. 1988 Feb;148(2):213.

Douglas WW, Tazelaar HD, Hartman TE, Hartman RP, Decker PA, Schroeder DR, et al. Polymyositis-dermatomyositis-associated interstitial lung disease. Am J Res Crit Care Med. 2001 Oct 1;164(7):1182-5.

Tembe AG, Ramteke S, Joshi VR, Balakrishnan C. Dermatomyositis/polymyositis associated with malignancy: our experience with ten patients and review of relevant literature. Int J Rheumatic Dis. 2008 Sep;11(3):269-73.

Buchbinder R, Forbes A, Hall S, Dennett X, Giles G. Incidence of malignant disease in biopsy-proven inflammatory myopathy: a population-based cohort study. Anna Int Med. 2001 Jun 19;134(12):1087-95.

Wakata N, Kurihara T, Saito E, Kinoshita M. Polymyositis and dermatomyositis associated with malignancy: a 30‐year retrospective study. Int J Dermatol. 2002 Nov;41(11):729-34.

Lee SW, Jung SY, Park MC, Park YB, Lee SK. Malignancies in Korean patients with inflammatory myopathy. Yonsei Med J. 2006 Aug 31;47(4):519-23.

Chen YJ, Wu CY, Huang YL, Wang CB, Shen JL, Chang YT. Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan. Arthritis Res Ther. 2010 Apr;12(2):R70.

Downloads

Published

2019-03-25

Issue

Section

Original Research Articles