Polymyositis (PM) by Melanie Loe

Our Team

melanie499022 — 2024-05-22 00:45:03 UTC

Melanie Nicole Stone 5007572

Claudia S. De León Jusino 5015296

Carla M. Denton Ortiz 5009109

Alejandra Jimenez 5007596

melanie499022 — 2024-05-22 02:20:24 UTC

jimenezalejandra1 — 2024-05-22 22:26:08 UTC

Begins with a physician’s exam and blood testing.
Muscle biopsy is a reliable instrument in the diagnosis of PM in close to 85% of the patients.
Patient presents high levels of muscle enzyme.
Creatine kinase levels are usually very high.

(Milisenda et al., 2014)

jimenezalejandra1 — 2024-05-22 22:26:33 UTC

Treated with high doses of corticosteroids (first course of treatment).
Immunosuppressive medications are considered methotrexate, cyclosporine, mycophenolate, and rituximab.
In severe cases of PM, intravenous infusion of immunoglobulins (IVIG) has been an effective treatment.
Physical therapy is important for treatment purposes.

(Milisenda et al., 2014)

cdentonortiz — 2024-05-23 17:49:34 UTC

melanie499022 — 2024-05-23 21:43:52 UTC

cdentonortiz — 2024-05-23 23:54:06 UTC

melanie499022 — 2024-05-24 01:49:00 UTC

Podcast

carla21denton — 2024-05-24 02:52:58 UTC

https://podcasts.apple.com/us/podcast/polymyositis-and-dermatomyositis-myositis/id1441247484?i=1000451406893

Opinion of case report

carla21denton — 2024-05-24 03:16:09 UTC

The patient presented with muscle weakness following exposure to cold water. After a physical examination, it was determined that the patient suffered from muscle tenderness in the shoulders and calves, and muscle weakness in the neck and lower limbs. After careful consideration the physician decided to perform a muscle biopsy to confirm Polymyositis. As a group we think that the patient management was adequate regarding the severity of the situation, and the treatment was within standard of care for this type of condition. However, a muscle biopsy is a very invasive procedure, there can be other ways to properly diagnose the condition, without taking such drastic measure, a blood test could be an example.

Relevant oficial website

carla21denton — 2024-05-24 03:19:18 UTC

Question

carla21denton — 2024-05-24 03:36:03 UTC

A 42-year-old woman comes to the physician because of a 2-month history of progressive muscular weakness. She has had difficulty climbing stairs, getting up from chairs, and brushing her hair. Her vital signs are within normal limits. Muscle strength is 2/5 with flexion of the hips and 3/5 with abduction of the shoulders. She is unable to stand up from her chair without the use of her arms for support. Laboratory studies show elevations in leukocyte count, erythrocyte sedimentation rate, and creatine kinase concentration. Histological evaluation of a biopsy specimen of the deltoid muscle is most likely to show which of the following?

A. Sarcolemmal MHC-I overexpression with CD8+ lymphocytic infiltration

Histological examination of skeletal muscles affected by polymyositis typically shows endomysial infiltration of CD8+ T cells and macrophages, with areas of muscle necrosis and regeneration of muscle fibers. In addition, overexpression of MHC-I on the sarcolemma is an immunohistochemical finding that is classic for polymyositis. Muscle atrophy is not a prominent feature of this disorder, in contrast to dermatomyositis. Polymyositis is associated with positive ANA (30–60% of cases), positive anti-Jo-1 (25% of cases), and malignancy (15–20% of cases).

Idiopathic inflammatory myopathies

GIVE FEEDBACK

B. Sarcoplasmic rimmed vacuoles with CD8+ lymphocytic infiltration

C. Relative atrophy of type II muscle fibers with hypertrophy of type I muscle fiber

D. Perimysial inflammation with perivascular CD4+ T lymphocytic infiltration

Scientific article

carla21denton — 2024-05-24 04:01:04 UTC