Rheumatology Dermatomyositis Mindomo Assignment

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Impacts of Heart Disease in Canada

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Dermatomyositis

Additional Testing

Electromyography

MRI

Detects muscle inflammation and damage

Muscle biopsy

Confirms diagnosis

Health Promotions

Healthy diet

Fruits, vegetables, whole grains, lean protein

Smoking cessation

Daily exercise to maintain and restore normal function

Treatment

Physical therapy

Vitamin D and calcium supplementation

If taking 5mg/day or more of steroids for more than 3 months

Glucocorticoid sparing immunosuppressive agents

Rituximab

Mycophenolate mofetil

Systemic glucocorticoids (prednisone)

Symptoms

Muscle weakness

Difficulty combing hair

Difficulty reaching overhead

Difficulty getting out of a car

Difficulty washing hair

Difficulty walking upstairs

Difficulty rising from a low chair

Symmetrical proximal muscle weakness

Insidious onset

Joint pain and swelling

Myalgias and muscle tenderness

Signs

Muscle atrophy

Reduced proximal muscle strength

Periungual telangiectasia

Calcinosis cutis

Mechanic's hands

Psoriasiform changes in scalp

Nailfold abnormalities

Holster sign

Poikilodermatous eruption

Facial erythema

Heliotrope eruption

Gottron sign

Gottron papules

Laboratory Testing

Myositis-specific autoantibodies

Anti-SRP

Anti-Mi-2

Anti-jo-1

Elevated ESR and CRP

Elevated CK, aldolase, AST, ALT, LDH

Pathophysiology

Perivascular and perimysial infiltration

Attack against muscle capillaries and endothelium

Antigen specific antibodies

Inflammatory myopathy

Genetics

Genetic component may be less than in other autoimmune disorders

Possible links to HLA alleles

Epidemiology

Occurs in 1 per 100,000 cases

Bimodal age distribution

10-15 years-old; 40-60 years-old

Etiology

Possible environmental factors including viruses (seasonal pattern of incidence)

Specific underlying cause is unknown