• Title/Summary/Keyword: idiopathic polymyositis

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Idiopathic Polymyositis Showing Nonspecific Clinical Signs that Mimicked Masticatory Myositis in a Dog

  • Soyoung Jung;Junghoon Park;Yeon-Jung Hong;Aryung Nam
    • Journal of Veterinary Clinics
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    • v.41 no.5
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    • pp.301-306
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    • 2024
  • Idiopathic polymyositis and masticatory myositis are autoimmune inflammatory myopathies seen in dogs. Here we report a case involving an 11-year-old spayed female mixed-breed dog with suspected masticatory myositis that was later confirmed to be idiopathic polymyositis. The dog presented with lethargy and reluctance to walk. Blood examination indicated markedly elevated creatine kinase and C-reactive protein levels. The owners were reluctant to proceed with advanced tests; however, the dog developed new clinical signs, including trismus. T2-weighted magnetic resonance imaging revealed hyperintensities in multiple muscle groups, with the most pronounced changes occurring in the masticatory muscles. During the waiting period for the results of serology for circulating autoantibodies against type 2M myofibers, oclacitinib was administered and slightly restored vitality and appetite. The antibody test result was negative, and histopathological examination of the temporalis muscle revealed severe inflammatory myopathy with fibroplasia. Although masticatory myositis was initially suspected on the basis of the MRI findings and the presence of trismus, the final diagnosis based on the overall clinical course and diagnostic test results was idiopathic polymyositis. Immunosuppressive treatment with prednisolone and mycophenolate mofetil substantially improved the clinical condition. The findings from this case suggest that, even in cases of idiopathic polymyositis exhibiting only nonspecific clinical signs, accurate diagnosis and timely treatment are essential to achieve satisfactory clinical outcomes.

Polymyositis Associated with Pancreatic Ductal Adenocarcinoma

  • Yoon Suk Lee
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.112-116
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    • 2022
  • Idiopathic inflammatory myopathy (IIM) is known for its association with malignant diseases. Moreover, various solid organ malignancies, such as ovarian, breast, lung, esophageal, stomach, and colorectal cancers, have been reported to occur with IIM. Furthermore, its relationship with hematologic malignancies, including non-Hodgkin lymphoma, myeloma, and leukemia, has been reported. However, to date, IIM related to pancreatic cancer has scarcely been reported, particularly in patients with polymyositis (PM). Therefore, here we report a case of PM developed immediately after the diagnosis of pancreatic ductal adenocarcinoma.

Idiopathic Polymyositis in a Young Mature Alaskan malamute (젊은 성숙 알라스칸 말라뮤트에서 특발성 다발성근염 증례)

  • Lee, Jae-Il;Hong, Sung-Hyeok;Son, Hwa-Young;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.244-246
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    • 2007
  • Clinical and histopathologic features of idopathic polymyositis in twenty-month-old Alaskan malamute dog are described. The clinical signs were progressive exercise intolerance with acute exacerbation of weakness, muscle atrophy, synchronous pelvic limb gait, short stiff steps and tip-toeing as like walking on eggshells. Physical and clinical examination revealed no evidence of neurologic, skeletal and secondary muscular disorders associated with other diseases. Therefore muscle biopsy was performed at the most severe muscle atrophy lesions to confirm by histopathology. Histopathologic findings documented mononuclear cell infiltration and necrosis of muscle fiber and it was diagnosed as idiopathic polymyositis. Initial treatment was focused on pain relief. Prednisone at immunosuppressive dose (2 mg/kg) was administered orally twice daily. After 3 weeks of starting treatment, the patient showed improvement of gait, appetite, exercise as well as gradually return to normal state of hematologic and serum chemistry profiles.

A Case Report on Polymyositis Treatment with Ohaeng-Hwa Acupuncture in Korean Medicine (오행화침법(五行和鍼法)을 적용한 다발성 근염 치료 1례)

  • Lee, Byung-Gwon;Kam, Chul-Woo;Park, Dong-Il;Han, Hyun-Young;Lee, Soo-Jung;Kwon, Kyoung-Man;Lee, Young-Jun
    • Korean Journal of Acupuncture
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    • v.27 no.4
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    • pp.119-127
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    • 2010
  • Objectives : Polymyositis is non-hereditary, autoimmune rheumatic disease, and one of the idiopathic inflammatory myopathy. It is characterized by progressive symmetrical proximal muscle weakness. Major clinical signs and symptoms of polymyositis are chronic non-suppurative inflammatation of skeletal muscle, elevation of muscle enzyme, and electromyographical changes. By use of Korean medicine treatments, muscle weakness and normalize muscle enzyme can be improved in case of polymyositis. Methods : A Patient, 32 years old, whom diagnosed with polymyositis on muscle biopsy and electromyographical changes, had medical treatments with Corticosteroids and Immunosuppressants, but no improvement was noted. She was treated with Korean Medicine, especially Ohaeng-Hwa Acupuncture(五行和 鍼法) and Ssanghwa-Tang(雙和湯) for three months period. Results : With Korean Medicine treatment of polymyositis for three months, most of her clinical signs and symptoms have been improved significantly, especially her muscle weakness and muscle enzyme level. Conclusion : This case has been reported to show that Korean medicine treatments have positive effects on polymyositis.

Bronchiolitis Obliterans Organizing Pneumonia as the First Manifestation of Polymyositis (다발성근염의 선행증상으로 나타난 폐쇄성 세기관지염 기질화 폐렴)

  • Lee, Jong-Hoon;Son, Choon-Hee;Jeong, Won-Tae;Lee, Ki-Nam;Lee, Young-Hoon;Choi, Pil-Jo;Jeong, Jin-Sook;Lee, Chang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.89-95
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    • 1999
  • Bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 40-year-old patient with fever, chillness, generalized myalgia and progressive exertional dyspnea, had bilateral interstitial infiltrates on chest radiograph. High-Resolution CT showed subpleural and peribronchial distribution of airspace consolidation. Open lung biopsy was consistent with BOOP. Prednisolone therapy led to improvement, but during tapering of prednisolone for 3 months to 30 mg, he complained of weakness of both lower legs. One month later, prednisolone was tapered to 15 mg a day, fever. chillness and generalized myalgia were recurred. He complained of weakness of both arms. The creatine kinase (CK) with MM isoenzyme, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were elevated. Anti-Jo1 antibody was positive. Vastus lateralis muscle biopsy was compatible with polymyositis. After injection of methylprednisolone for 1 week, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, LDH, AST levels declined significantly. Patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.

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A Case of Antisynthetase Syndrome (항 Synthetase 증후군 1예)

  • Kim, Min-Jeong;Kim, Min Ah;Kim, Eung-Gyu;Kim, Chan-Hwan;Kim, Sang-Jin
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.196-198
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    • 2006
  • It has been reported that antisynthetase syndrome belongs to the idiopathic myositis group which includes pulmonary interstitial disease, arthritis, Raynaud's phenomenon, and mechanic's hand, associated with the anti-Jo1 antibody. A 60- year-old man presented with one month history of lower limbs weakness, rapidly progressive exertional dyspnea, and arthralgia. A markedly increased titers of anti-Jo1 antibodies were found. Chest CT showed idiopathic pulmonary fibrosis. Muscle biopsies were consistent with polymyositis. A high dose corticosteroids and cyclosporine were not effective. We report a case of antisynthetase syndrome, in which immunosuppressive agents could not rescue the deteriorating disease course.

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The Clinical Usefulness of Transbronchial Lung Biopsy in Critically III Patients with Pulmonary Infiltrates of Uncertain Etiology (폐 침윤과 호흡부전을 동반한 중환자에서 경기관지폐생검의 임상적 유용성에 관한 연구)

  • Jang, Eun-Ha;Koh, Youn-Suck;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Go, Yun-Seok
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.236-245
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    • 2000
  • Background: Transbronchial lung biopsy(TBLB) has known to yield useful information for pulmonary infiltrates of uncertain etiology, However, its safety and usefulness have not been conclusive in the critically ill patients with respiratory failure. Moreover, TBLB has not been recommended for patients with mechanical ventilation. This study was conducted to investigate the diagnostic values and risks of Will performed on critically ill patients at bedside to obtain information on the pulmonary infiltrate of unknown etiology. Methods: Twenty patients(21 admissions with 23 cases) with diffuse pulmonary infiltrates who were treated in a medical intensive care unit of a tertiary referral hospital from January 1994 to May 1998, were enrolled for the study. Their medical records were retrospectively reviewed. TBLB was opted when a noninvasive diagnostic work-up failed to reveal the cause for the pulmonary infiltrate. The procedure was performed at patients' bedside without assistance of fluoroscopy. Bronchial washing or bronchoalveolar lavage was performed on the same pulmonary segment before performing TBLB. Results: Adequate specimens were obtained in 18 cases(78%). TBLB provided a specific diagnosis in two cases. The results of TBLB suggested the underlying etiology in 9 cases; bacterial pneumonitis(4), hypersensitivity pneumonitis(1), polymyositis(1), radiation fibrosis(1), idiopathic pulmonary fibrosis(1), and BOOP(1). Therapeutic decisions were altered in 11 cases(47.8%) based on the TBLB results. Pneumocystis carinii was found in the BAL fluid of another case. Ten patients with a therapeutic change and ten patients without a management change had mortality rates of 40% and 80%, respectively. The APACHE III scores were significantly higher in patients with complications($72.8{\pm}21.8$) compared with those without complications ($48.3{\pm}18.9$)(p<0.05). The complication rates were higher in those with mechanical ventilation(50%) than in those without Mechanical ventilation(33%), but the difference was not statistically significant(p=0.3). Conclusions: TBLB may be a useful diagnostic option for critically ill patients with unknown cause of pulmonary infiltrates. However, it should be cautious be used with care for patients with mechanical ventilation or for severely ill patients.

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