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🌱 來自: inflammatory myopathies

Clinical manifestations of inflammatory myopathies

• Muscle weakness:
  • typically gradual onset (wks to mos) but often accelerated in NM (days to wks) and more insidious (yrs) in IBM;
  • progressive and painless
• DM/PM/NM:
  • proximal and symmetric;
  • difficulty climbing stairs, arising from chairs, brushing hair;
  • fine motor skills (eg, buttoning) lost late
• IBM: weakness may be asymmetric, distal, and involve facial muscles
• Skin findings in dermatomyositis: may precede myositis by mos to yrs
  • Gottron’s papules:
  • Heliotrope rash:
  • Poikiloderma:
  • Mechanic’s hands:
• Pulmonary: acute alveolitis, interstitial lung disease; resp muscle weakness; aspiration
  • Antisynthetase syndrome
  • MDA5-assoc. DM: ↑ amyopathic, ↑ rapidly progressive ILD, palmar papules, skin ulcers
• Cardiac: (33%): often asx;
  • conduction abnl;
  • myo/pericarditis;
  • HF uncommon;
  • ↑ CK-MB/Tn
• GI: dysphagia, aspiration
• Polyarthralgias or polyarthritis: usually early, nonerosive; small joints >large joints
• Raynaud’s (30%, DM and overlap CTD) w/ dilatation & dropout of nail bed capillaries