Polymyositis and Dermatomyositis: Causes, Symptoms, Diagnosis, Treatment

 Polymyositis and Dermatomyositis :

In these diseases, initially the process of inflammation occurs in the muscles and the muscles start becoming emaciated-wasted. The main symptom of this disease is the weakness of the muscles that gradually increases and makes the patient handicapped. Reddish erythema is seen on the face, back, chest, elbows and knees of the patient. There can be pain in muscles in 50 per cent of cases.

 

Causes :

These diseases are not hereditary diseases. Changes in the protective immune system of the body, produce cells, which destroy the cells of the muscles and hence this disease occurs. It should be noted that this disease is not contagious.

 

Symptoms :

The symptoms, their intensity and the rate of development shows a lot of variation. Weakness in the muscles spreads in a few months. Some times it may hold back, but in most of the cases ifthe right treatment is not taken, the weakness keeps on increasing gradually.

The patient’s gait (walk) becomes unstable and he starts falling frequently. With the passage of time.the patient is unable to walk and becomes bed-ridden. In the rapidlyincreasing disease, the possibility of cure is greater. Approximately SO% of the patients improve with medicines. Patients suffer from pain in the muscles specially while climbing steps, getting up from the chair, raising the hand up etc. Many a times there is difficulty in swallowing solids and liquids, and respiratory distress. This disease is usually seen after the age of 18.

 

Diagnosis :

Along with the above mentioned symptoms :

·           There is an increase in the proportion of C.P.K. in blood.

 

·           The investigations like E.M.G., N.C.V. are considered very useful for diagnosis.

 

·           In muscle biopsy, the muscle sample shows obvious changes, which is confirmative of diagnosis.

 

Treatment :

(A) Medicines :

1.        Steroids like Prednisolone, Methyl Prednisolone, and Dexamethasone.

 

2.        Immuno suppressive drugs like Azathioprine, Methotrexate, Cylophosphamide.

 

3.        Cyclosporin: This drug helps in controlling the disease well, but in the long run the side effects of the medicine are seen.

 

(B) Plasmapheresis :

This procedure involves purification of blood by removal of the abnormal proteins to control the disease.

C) Immunoglobulin :

Intravenous administration of this drug is beneficial, but this treatment is very expensive. Along with this, the importance of physiotherapy cannot be neglected. If physiotherapy is done regularly everyday, it can prevent the muscles from deteriorating to a certain extent.

It is important to get immediate advice from the doctor instead of considering the problem as an ordinary pain and letting it deteriorate further