Polymyositis and dermatomyositis diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
[[Muscle biopsy]] is the gold standard test for the diagnosis of polymyositis and dermatomyositis. [[Necrosis]], increase in endomysial and perimysial [[connective tissue]], [[atrophy]] and [[degeneration]] of both type I and II fibers, especially in a perifascicular distribution might be seen in [[muscle biopsy]]. | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
* [[Muscle biopsy]] is the gold standard test for the diagnosis of polymyositis and dermatomyositis.<ref name="BohanPeter1975">{{cite journal|last1=Bohan|first1=Anthony|last2=Peter|first2=James B.|title=Polymyositis and Dermatomyositis|journal=New England Journal of Medicine|volume=292|issue=8|year=1975|pages=403–407|issn=0028-4793|doi=10.1056/NEJM197502202920807}}</ref> | * [[Muscle biopsy]] is the gold standard test for the diagnosis of polymyositis and dermatomyositis.<ref name="BohanPeter1975">{{cite journal|last1=Bohan|first1=Anthony|last2=Peter|first2=James B.|title=Polymyositis and Dermatomyositis|journal=New England Journal of Medicine|volume=292|issue=8|year=1975|pages=403–407|issn=0028-4793|doi=10.1056/NEJM197502202920807}}</ref><ref name="DoblougGaren2015">{{cite journal|last1=Dobloug|first1=Cecilie|last2=Garen|first2=Torhild|last3=Bitter|first3=Helle|last4=Stjärne|first4=Johan|last5=Stenseth|first5=Guri|last6=Grøvle|first6=Lars|last7=Sem|first7=Marthe|last8=Gran|first8=Jan Tore|last9=Molberg|first9=Øyvind|title=Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort|journal=Annals of the Rheumatic Diseases|volume=74|issue=8|year=2015|pages=1551–1556|issn=0003-4967|doi=10.1136/annrheumdis-2013-205127}}</ref><ref name="ChinoyFertig2007">{{cite journal|last1=Chinoy|first1=H.|last2=Fertig|first2=N.|last3=Oddis|first3=C. V|last4=Ollier|first4=W. E R|last5=Cooper|first5=R. G|title=The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis|journal=Annals of the Rheumatic Diseases|volume=66|issue=10|year=2007|pages=1345–1349|issn=0003-4967|doi=10.1136/ard.2006.068502}}</ref><ref name="DalakasHohlfeld2003">{{cite journal|last1=Dalakas|first1=Marinos C|last2=Hohlfeld|first2=Reinhard|title=Polymyositis and dermatomyositis|journal=The Lancet|volume=362|issue=9388|year=2003|pages=971–982|issn=01406736|doi=10.1016/S0140-6736(03)14368-1}}</ref><ref name="DouglasTazelaar2001">{{cite journal|last1=Douglas|first1=William W.|last2=Tazelaar|first2=Henry D.|last3=Hartman|first3=Thomas E.|last4=Hartman|first4=Robert P.|last5=Decker|first5=Paul A.|last6=Schroeder|first6=Darrell R.|last7=Ryu|first7=Jay H.|title=Polymyositis–Dermatomyositis-associated Interstitial Lung Disease|journal=American Journal of Respiratory and Critical Care Medicine|volume=164|issue=7|year=2001|pages=1182–1185|issn=1073-449X|doi=10.1164/ajrccm.164.7.2103110}}</ref> | ||
* The following result of [[muscle biopsy]] is confirmatory of polymyositis and dermatomyositis: | * The following result of [[muscle biopsy]] is confirmatory of polymyositis and dermatomyositis: | ||
** Necrosis | ** [[Necrosis]] | ||
** Phagocytosis | ** [[Phagocytosis]] | ||
** Regenerative activity reflected by basophilia, large, vesicular nuclei and prominent nucleoli | ** [[Regenerative]] activity reflected by [[basophilia]], large, vesicular [[Cell nucleus|nuclei]] and prominent [[Nucleolus|nucleoli]] | ||
** Atrophy and degeneration of both | ** [[Atrophy]] and [[degeneration]] of both type I and II fibers, especially in a perifascicular distribution | ||
** Internal migration of nuclei | ** Internal migration of [[Cell nucleus|nuclei]] | ||
** Vacuolization | ** [[Vacuolization]] | ||
** Fiber-size variation | ** Fiber-size variation | ||
** Mononuclear inflammatory infiltrate, often most prominent in a perivascular location | ** [[Monocyte|Mononuclear]] inflammatory infiltrate, often most prominent in a perivascular location | ||
** Increase in endomysial and perimysial connective tissue | ** Increase in endomysial and perimysial connective tissue | ||
* The [[muscle biopsy]] should be performed when: | * The [[muscle biopsy]] should be performed when: | ||
** The patient presented with symptoms of [[muscle weakness]] and [[skin rash]] | ** The patient presented with symptoms of [[muscle weakness]] and [[skin rash]] | ||
** An elevated level of | ** An elevated level of muscle enzymes is detected in the patient. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:08, 18 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Muscle biopsy is the gold standard test for the diagnosis of polymyositis and dermatomyositis. Necrosis, increase in endomysial and perimysial connective tissue, atrophy and degeneration of both type I and II fibers, especially in a perifascicular distribution might be seen in muscle biopsy.
Diagnostic Study of Choice
- Muscle biopsy is the gold standard test for the diagnosis of polymyositis and dermatomyositis.[1][2][3][4][5]
- The following result of muscle biopsy is confirmatory of polymyositis and dermatomyositis:
- Necrosis
- Phagocytosis
- Regenerative activity reflected by basophilia, large, vesicular nuclei and prominent nucleoli
- Atrophy and degeneration of both type I and II fibers, especially in a perifascicular distribution
- Internal migration of nuclei
- Vacuolization
- Fiber-size variation
- Mononuclear inflammatory infiltrate, often most prominent in a perivascular location
- Increase in endomysial and perimysial connective tissue
- The muscle biopsy should be performed when:
- The patient presented with symptoms of muscle weakness and skin rash
- An elevated level of muscle enzymes is detected in the patient.
References
- ↑ Bohan, Anthony; Peter, James B. (1975). "Polymyositis and Dermatomyositis". New England Journal of Medicine. 292 (8): 403–407. doi:10.1056/NEJM197502202920807. ISSN 0028-4793.
- ↑ Dobloug, Cecilie; Garen, Torhild; Bitter, Helle; Stjärne, Johan; Stenseth, Guri; Grøvle, Lars; Sem, Marthe; Gran, Jan Tore; Molberg, Øyvind (2015). "Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort". Annals of the Rheumatic Diseases. 74 (8): 1551–1556. doi:10.1136/annrheumdis-2013-205127. ISSN 0003-4967.
- ↑ Chinoy, H.; Fertig, N.; Oddis, C. V; Ollier, W. E R; Cooper, R. G (2007). "The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis". Annals of the Rheumatic Diseases. 66 (10): 1345–1349. doi:10.1136/ard.2006.068502. ISSN 0003-4967.
- ↑ Dalakas, Marinos C; Hohlfeld, Reinhard (2003). "Polymyositis and dermatomyositis". The Lancet. 362 (9388): 971–982. doi:10.1016/S0140-6736(03)14368-1. ISSN 0140-6736.
- ↑ Douglas, William W.; Tazelaar, Henry D.; Hartman, Thomas E.; Hartman, Robert P.; Decker, Paul A.; Schroeder, Darrell R.; Ryu, Jay H. (2001). "Polymyositis–Dermatomyositis-associated Interstitial Lung Disease". American Journal of Respiratory and Critical Care Medicine. 164 (7): 1182–1185. doi:10.1164/ajrccm.164.7.2103110. ISSN 1073-449X.