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Myositis - Types, Symptoms, Causes, Treatment, and Prognosis

Published on Sep 29, 2022 and last reviewed on Jan 30, 2023   -  4 min read

Abstract

The term "myositis" refers to a set of uncommon diseases. To know more about myositis, read the full article below.

What Is Myositis?

The term "myositis" refers to a set of uncommon diseases. Muscle weakness, soreness, and discomfort are the most common symptoms. This normally deteriorates over time. Myositis is caused by immune system malfunction, which causes it to target healthy tissue by mistake.

What Are the Types of Myositis?

Many acquired disorders are characterized by muscle inflammation and muscular weakening of myositis. They are as follows:

Polymyositis + Dermatomyositis = Inflammatory myopathies(IMs)

What Are Inflammatory Myopathies?

Polymyositis and dermatomyositis are predominantly described under the generic inflammatory myopathy. It affects various organs. Interstitial lung disease and dysphagia are the more fatal complications of inflammatory myopathies. This disease occurs most commonly in men over fifty years of age.

What Are the Symptoms of Polymyositis?

Polymyositis affects a wide range of muscles; however, it is most common in the shoulders, neck, hip, back, and thighs. The symptoms include weak and painful muscles, difficulty sitting and standing, dysphagia, tiredness, and depression. If not treated, the muscle weakness and pain worsen every week.

What Are the Symptoms of Dermatomyositis and Myositis?

Patients with dermatomyositis suffer from distinct rashes and weak and painful muscles in polymyositis. The rashes usually start as red or purple and then become dark. Most commonly occurs in the face and neck region. The rashes will be associated with itch and pain. A lump might also develop beneath the skin.

The other common symptoms of myositis are weakness and tiredness of muscles that can make daily routine difficult, muscle pain, pain on touch in the affected muscles, swollen muscles, feeling sick, weight loss, and sweating at night. The neck, hips, shoulders, and thigh muscles are most commonly affected.

What Are the Other Medical Conditions That Can Mimic Myositis?

Side effects of using steroids and statins, prolonged duration of alcohol consumption, hyper and hypothyroidism, vitamin D deficiency, varied calcium and magnesium levels, and clothes muscle-related abnormalities can mimic myositis clinically.

What Are the Tests to Diagnose Myositis?

  • Blood Tests:

    • Antinuclear Antibodies (ANA): To check for antibodies

    • Extractable Nuclear Antigens (ENA): To check for autoantibodies (treatment response)

  • Electromyography (EMG): Myositis is characterized by an atypical electrical activity pattern in a variety of muscles. This test is painless and a little uncomfortable.

  • Muscle Biopsy: Usually done in large muscles to check for inflammation. This can also be repeated if you do not respond to treatment as expected to check for proteins in the inclusion of body myositis.

  • Magnetic Resonance Imaging (MRI): This imaging can pick up areas of inflammation and sometimes areas of muscle damage, where the affected part of the muscle is replaced with fat.

How to Treat Myositis?

Steroids are the drug of choice for myositis, with a higher dose initially. Steroids are available both in tablet and injectable form. They instantly reduce inflammation, relieve muscle pain, and alleviate the feeling of being sick. Because high doses of steroids might have side effects, it is advisable to gradually reduce the dose. Long-term use of steroids raises the chance of developing osteoporosis, a disorder that causes bones to weaken and collapse more easily.

You can take medications in addition to steroids to lower your risk of getting osteoporosis. Bisphosphonates, for example, can help decrease bone loss. When the steroid dose is reduced, the manifestations of myositis may flare up, and your doctor may recommend other drugs to help lessen the inflammation. Routine blood tests will be required to check for probable side effects when using disease-modifying antirheumatic medications (DMARDs).

Drugs available for the management of myositis are

  • DMARD: Cyclophosphamide.

  • Biological therapy: Rituximab.

  • Immunoglobulin.

Biological Treatments:

Function by inhibiting certain immune system targets that induce inflammation. Immunoglobulins are antibodies derived from healthy people's blood donations that can prevent your immune system from attacking your tissues. This medication is normally administered as an intravenous infusion. During the therapy, you may feel a little sick at times. Myositis normally responds to therapy, even in extreme symptoms, though many people require lifelong medication to keep their illness under control.

Exercise:

Whenever the myositis is very severe, it's probably best to relax, but regular exercise can substantially relieve your symptoms and general wellbeing once it has settled down. Aerobic exercise helps you to breathe easier and your heartbeat quicker. It is particularly beneficial for restoring muscle strength and increasing stamina. At the beginning level, this should be done under the guidance of a physiotherapist who will create a personalized program for you. Physically demanding or intensive exercises should be avoided.

Physiotherapy:

To minimize the chance of extremities, especially the legs, becoming permanently bent, individuals suffering juvenile dermatomyositis will require more intense physiotherapy. Many features of the condition will be considerably improved if you exercise regularly and as regularly as possible.

What Are the Complications of Myositis?

Drug therapies may not always be effective, and muscles may remain weak. Lung inflammations can lead to scarring, altering how the lungs function. Long-term breathlessness can be caused by lung and cardiac diseases. If patients have a risk of developing these diseases, they should be referred to either a cardiologist or a pulmonologist. Calcium deposits in the injured muscles of children with dermatomyositis can be uncomfortable. These deposits can cause contractures and permanently inflexible joints when combined with a loss of movement. Myositis has been linked to cancer on rare occasions. The majority of myositis patients do not get cancer.

How Does Myositis Affect Prognosis?

Myositis patients can make a full recovery. On the other hand, some persons with severe symptoms might not fully recover. Even for those who fully recover, it can take months to see results because treatments require time to help the body restore muscles. People may become quite weary as a result of this.

Conclusion:

Many people with myositis respond to various steroids and immunosuppressive therapies. Steroids are often needed in low doses, but most cases can be easily managed with antibiotics.

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Last reviewed at:
30 Jan 2023  -  4 min read

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