によって Nina Bharadwaj 2年前.
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Rheumatology Dermatomyositis Mindomo Assignment
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
