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Old 09-26-2011
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Default Complication of Inflammatory Myopathy.

Can anyone tell most common Malignancy associated with polymyositis ???
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Old 09-26-2011
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Dermatomyositis (DM) and polymyositis (PM) are two distinct forms of inflammatory myopathy. Both DM and PM are associated with malignancies in a significant minority of cases. The relative risk of malignancy appears to be somewhat higher among patients with DM than among those with PM. Cancer can be diagnosed before, simultaneously with, or after the diagnosis of inflammatory myopathy. Adenocarcinomas of the cervix, lung, ovaries, pancreas, bladder, and stomach account for approximately 70 percent of the cancers associated with inflammatory myopathies. Several studies suggest that the risk of ovarian cancer may be particularly increased . In some populations, the types of malignancy associated with DM or PM reflect cancers found in particularly high prevalence within that population. As an example, Southeast Asian patients with DM are at increased risk of nasopharyngeal carcinoma.
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Old 09-26-2011
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can you throw some light on how to differentiate other myopathies presenting with proximal muscle involvement
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Old 09-26-2011
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atleast the typical clinical points to differentiate r

  • hyperthyriodism...other features..check tsh
  • PM... typical symtoms of proximal myopathy withour rash
  • DM---PM symtoms plus guttrons papules n lilac rash in shawl distribution
  • h/o steriod use may point to steriod induced myopathy
  • acute course (days to wks), proxmal muscles plus ascending paralysis---GBS
  • more acute course, (within hrs-days) similar presentation as gbs, h/o camping or travel---tick paralysis
EMG is confirmatory for gbs, tick paralysis...whereas EMG is follwed by muscle biopsy in PM,DM, steriod use.

Also muscular dystrphies present with proximal weaknes...imp ones r duchenne n myotonic..
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Old 09-26-2011
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Causes of Proximal Muscle Weakness

  • Inflammatory myositis : The three main types of chronic, or persistent, inflammatory myopathy are polymyositis, dermatomyositis, and inclusion body myositis.
  • Endocrine myopathy: (1) adrenal dysfunction (as in Cushing disease or steroid myopathy); (2) thyroid dysfunction (as in myxedema coma or thyrotoxic myopathy); (3) parathyroid dysfunction (as in multiple endocrine neoplasia); (4) pituitary dysfunction; and (5) islands of Langerhans dysfunction (as in diabetic myopathy).
  • Drugs: Steroid . Statins therapy. Cyclosporin
  • Hypokalemia
  • Myasthenia gravis
  • congenital myopathies
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how to diff DM/PM from polymaylgia rheumaticia if no syx of temporal arteritis
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Polymyalgia rheumatica: Pain & stiffness in shoulder & pelvic girdle muscles, no lab finding of muscle destruction, eg increased CPK. While in idiopathic inflammatory myopathesis (DM/PM) CK level is significantly elevated.
Polymyalgia rheumatica: joint swelling & synovitis in up to 20% of cases, profound morning stiffness is common. Constitutional symptoms. As you referred to temporal arteritis if present points to Polymyalgia rheumatica (10% of PMR develop temporal arteritis, whereas up to 40% -50% of people with temporal arteritis have coexisting PMR.
All these points can help to differentiate, please add to that. Bottom of Form
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