Polymyositis and dermatomyositis natural history, complications and prognosis

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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

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of polymyositis and dermatomyositis usually develop very slowly and progressively from proximal muscle weakness to distal muscle weakness.[1]
  • Polymyositis and dermatomyositis usually do not affect facial muscles.
  • Patients might experience myalgia and muscle tenderness in the early stages of polymyositis.
  • In dermatomyositis, skin manifestations develop and after few months to years myositis will occur.
  • The symptoms of (disease name) typically develop ___ years after exposure to ___.
  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

Complications

  • Common complications of polymyositis and dermatomyositis include:[2]
    • Malignancy
      • Risk of malignancy in dermatomyositis is 5-7 fold more than the general population
    • Cardiac complications
      • Arrhythmia
      • Conduction abnormalities
      • Cardiac arrest
      • Congestive heart failure (CHF)
      • Myocarditis
      • Pericarditis
      • Angina
      • Secondary fibrosis
    • Pulmonary complications
      • Hypoventilation and respiratory failure
      • Aspiration pneumonia
      • Interstitial lung disease
    • Gastrointestinal complications
      • Dysphagia
      • Proximal esophageal skeletal muscle dysfunction

Prognosis

  • Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
  • Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
  • The presence of extramuscular organ involvement, such as lung and cardiac involvement are associated with a particularly poor prognosis among patients with polymyositis and dermatomyositis.
  • Cardiovascular involvement is associated with the poor prognosis and is one of the most common causes of death in patients with polymyositis and dermatomyositis.
  • Pulmonary involvement is associated with increased morbidity and mortality in patients with polymyositis and dermatomyositis.

References

  1. Khan, Sabiha; Christopher-Stine, Lisa (2011). "Polymyositis, Dermatomyositis, and Autoimmune Necrotizing Myopathy: Clinical Features". Rheumatic Disease Clinics of North America. 37 (2): 143–158. doi:10.1016/j.rdc.2011.01.001. ISSN 0889-857X.
  2. Barnes BE, Mawr B (January 1976). "Dermatomyositis and malignancy. A review of the literature". Ann. Intern. Med. 84 (1): 68–76. PMID 1106291.