Polymyositis and dermatomyositis diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Muscle biopsy is the gold standard test for the diagnosis of polymyositis and dermatomyositis. Necrosis, increase in endomysial and perimysial connective tissue, atrophy and degeneration of both type I and II fibers, especially in a perifascicular distribution might be seen in muscle biopsy. The muscle biopsy should be performed when a patient presented with symptoms of muscle weakness and skin rash or elevated level of muscle enzymes.
Diagnostic Study of Choice
- Muscle biopsy is the gold standard test for the diagnosis of polymyositis and dermatomyositis.[1][2][3][4][5]
- The following result of muscle biopsy is confirmatory of polymyositis and dermatomyositis:
- Necrosis
- Phagocytosis
- Regenerative activity reflected by basophilia, large, vesicular nuclei and prominent nucleoli
- Atrophy and degeneration of both type I and II fibers, especially in a perifascicular distribution
- Internal migration of nuclei
- Vacuolization
- Fiber-size variation
- Mononuclear inflammatory infiltrate, often most prominent in a perivascular location
- Increase in endomysial and perimysial connective tissue
- The muscle biopsy should be performed when:
- The patient presented with symptoms of muscle weakness and skin rash
- An elevated level of muscle enzymes is detected in the patient.
References
- ↑ Bohan, Anthony; Peter, James B. (1975). "Polymyositis and Dermatomyositis". New England Journal of Medicine. 292 (8): 403–407. doi:10.1056/NEJM197502202920807. ISSN 0028-4793.
- ↑ Dobloug, Cecilie; Garen, Torhild; Bitter, Helle; Stjärne, Johan; Stenseth, Guri; Grøvle, Lars; Sem, Marthe; Gran, Jan Tore; Molberg, Øyvind (2015). "Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort". Annals of the Rheumatic Diseases. 74 (8): 1551–1556. doi:10.1136/annrheumdis-2013-205127. ISSN 0003-4967.
- ↑ Chinoy, H.; Fertig, N.; Oddis, C. V; Ollier, W. E R; Cooper, R. G (2007). "The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis". Annals of the Rheumatic Diseases. 66 (10): 1345–1349. doi:10.1136/ard.2006.068502. ISSN 0003-4967.
- ↑ Dalakas, Marinos C; Hohlfeld, Reinhard (2003). "Polymyositis and dermatomyositis". The Lancet. 362 (9388): 971–982. doi:10.1016/S0140-6736(03)14368-1. ISSN 0140-6736.
- ↑ Douglas, William W.; Tazelaar, Henry D.; Hartman, Thomas E.; Hartman, Robert P.; Decker, Paul A.; Schroeder, Darrell R.; Ryu, Jay H. (2001). "Polymyositis–Dermatomyositis-associated Interstitial Lung Disease". American Journal of Respiratory and Critical Care Medicine. 164 (7): 1182–1185. doi:10.1164/ajrccm.164.7.2103110. ISSN 1073-449X.