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Myositis is a rare autoimmune disease that causes muscle weakness and inflammation. It is one of a group of inflammatory myopathies, or idiopathic inflammatory myopathies, that affect the muscles and can also impact the skin and other organs. Myositis can occur with other conditions, such as lupus or rheumatoid arthritis, and it can affect people of all ages. Polymyalgia rheumatica is another inflammatory condition that causes muscle stiffness, pain, and aches, mainly in the shoulders and hips. Myasthenia gravis is an autoimmune disorder that causes weakness in the skeletal muscles, particularly in the eyes, mouth, throat, and limbs. These are just a few examples of autoimmune diseases that can cause muscle tightness and weakness, impacting individuals' daily lives and activities.
| Characteristics | Values |
|---|---|
| Name of Autoimmune Disease | Myositis, Polymyositis, Dermatomyositis, Myasthenia Gravis, Polymyalgia Rheumatica |
| Symptoms | Muscle weakness, inflammation, irritation, pain, difficulty swallowing, difficulty breathing, skin rashes, muscle breakdown, stiffness, weight loss, malnutrition, difficulty lifting arms, climbing stairs, or sitting up |
| Diagnosis | Blood tests, muscle biopsies, electromyogram (EMG), MRI, physical exam, medical history |
| Treatment | Physical therapy, speech therapy, diet changes, emotional support, anti-inflammatory medicines, immunosuppressive medicines, corticosteroids, immunoglobulin, anticholinesterase medicines |
| Age Group | Polymyositis: 31-60, rarely under 18; Myositis: 30-60; Polymyalgia Rheumatica: over 65, rarely under 50 |
| Gender | More common in women |
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What You'll Learn
Myositis
There are different forms of myositis, including polymyositis, dermatomyositis, and inclusion body myositis. Polymyositis affects multiple muscles simultaneously and is characterised by symptoms in the centre of the body. It often causes difficulty in performing everyday movements and can lead to severe complications if left untreated. Dermatomyositis affects both the skin and muscles, and can develop quickly or over several months. Inclusion body myositis is another form of myositis, but its specific characteristics are not commonly mentioned.
The diagnosis of myositis can be challenging and time-consuming due to its similarity to other autoimmune diseases and the rarity of the condition. The diagnostic process typically involves a medical history review, a physical examination, and various tests, such as blood tests, muscle enzyme tests, electromyograms, and muscle biopsies. Treatment options for myositis include physical therapy, speech therapy, diet changes, emotional support, and medications such as corticosteroids, immunosuppressants, and immunoglobulin. Early treatment is crucial to slow down the progression of the disease and prevent severe complications.
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Polymyositis
The symptoms of polymyositis include muscle pain and weakness, difficulty breathing, swallowing, and speaking, as well as problems with walking and running. Women are more than twice as likely to be diagnosed with polymyositis than men. The disease can also occur alongside other autoimmune conditions such as lupus, rheumatoid arthritis, and Raynaud's disease.
There is currently no cure for polymyositis, but treatments can help manage symptoms and reduce their impact on daily life. Treatment options include anti-inflammatory medications such as steroids or corticosteroids, immunosuppressive medications, physical therapy, speech therapy, diet changes, and emotional support. Blood tests, muscle biopsies, MRIs, and EMGs are used to diagnose polymyositis and rule out other conditions with similar symptoms.
Starting treatment as soon as possible is important to minimize complications and slow down the progression of the disease. While polymyositis does not usually affect life expectancy, it can cause fatal complications, especially if it severely affects the neck and throat muscles, making it difficult to breathe or swallow. Therefore, it is crucial to seek medical attention if experiencing any of the symptoms associated with polymyositis.
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Dermatomyositis
The exact cause of dermatomyositis is unknown, but it is believed to be associated with autoimmune diseases, where the body's immune system attacks its own tissues. It can also be triggered by environmental factors such as viral infections, sun exposure, or certain medications. The condition can cause a range of symptoms, including muscle weakness, skin rash, nail changes, alopecia, joint pain, and swallowing difficulties. Complications may include lung disease, heart disease, and cancer.
Diagnosis of dermatomyositis typically involves a careful clinical evaluation, including a detailed medical history and physical examination. Blood tests, electromyelogram (EMG), magnetic resonance imaging (MRI), and muscle or skin biopsies may also be used to confirm the diagnosis and assess the extent of the disease.
While there is no cure for dermatomyositis, early diagnosis and treatment can help manage symptoms and improve outcomes. Treatment options include medication such as corticosteroids and immunosuppressants, physical therapy, exercise, heat therapy and rest. Dietary changes and emotional support are also recommended to help manage the condition and improve quality of life.
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Myasthenia gravis
Diagnosing myasthenia gravis typically involves a physical and neurological examination, including a review of the patient's medical history. Several tests can confirm the diagnosis, including repetitive nerve stimulation, single-fiber electromyography (EMG), and blood tests to detect elevated levels of acetylcholine receptor antibodies or anti-MuSK antibodies. Treatment for myasthenia gravis aims to increase muscle function and prevent swallowing and breathing problems. Anticholinesterase medicines, steroids, and immunosuppressive medications may be used to improve muscle strength and manage symptoms. In some cases, surgical removal of the thymus gland, called thymectomy, may be considered, as the thymus gland is associated with immune function and may play a role in the disease.
While there is no cure for myasthenia gravis, early detection and prompt medical management can help patients lead longer and more functional lives. With treatment, most people with this condition can improve their muscle strength and lead normal or near-normal lives. However, it is important to note that myasthenia gravis is a lifelong medical condition that requires ongoing management.
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Idiopathic inflammatory myopathies
There are several forms of IIM, including polymyositis, dermatomyositis, and sporadic inclusion body myositis. Polymyositis and dermatomyositis involve weakness of the muscles closest to the centre of the body (proximal muscles), such as the muscles of the hips, thighs, upper arms, and neck. Polymyositis is a disease that causes muscles to become irritated and inflamed, eventually breaking down and becoming weak. This can affect muscles all over the body and make even simple movements hard to do. Dermatomyositis has similar symptoms but is distinguished by a reddish or purplish rash on the eyelids, elbows, knees, or knuckles. Sometimes, abnormal calcium deposits form hard, painful bumps under the skin (calcinosis). In sporadic inclusion body myositis, the muscles most affected are those of the wrists and fingers and the front of the thigh. Affected individuals may frequently stumble while walking and find it difficult to grasp items.
The diagnosis of IIM can be challenging due to the many potential clinical features and extra-muscular manifestations that may seem unrelated. An accurate diagnosis requires an up-to-date understanding of the clinical manifestations, different clinical subtypes, and appropriate interpretation of investigations, including newly described serological subtypes. Blood tests can be done to look for signs of muscle inflammation and check for abnormal proteins that form in an autoimmune disease. Electromyelogram (EMG) may be done to find abnormal electrical activity in affected muscles, and MRI uses large magnets and a computer to look for inflammation in the body. Muscle biopsy is considered the most definitive test for diagnosis, allowing confirmation of muscle inflammation, identification of IIM subtype, and distinction from non-IIM forms of myopathy. Testing for myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) can further identify clinical subtypes, inform the requirement for further investigations, and predict treatment responses.
There is no known cure for IIM, but symptoms can be managed with treatments such as anti-inflammatory medicines (steroid medicines or corticosteroids), immunosuppressive medicines, physical therapy, speech therapy, and diet changes. Emotional support through an autoimmune disease support group or counselling can also help individuals manage their health.
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