Inflammatory myopathies idiopathic

Rider LG, Artlett CM, Foster CB, Ahmed A, Neeman T, Chanock SJ, Jimenez SA, Miller FW, for the Childhood Myositis Heterogeneity Collaborative Study Group (2000) Polymorphisms in the IL-1 receptor antagonist gene VNTR are responsible risk factors for juvenile idiopathic inflammatory myopathies. Clin Exp Immunol, 121 47-52. 

Lee CS, Chen TL, Tzen CY, et al. Idiopathic inflammatory myopathy with diffuse alveolar damage. CUn Rheumatol 2002 21 391 396. 

The idiopathic inflammatory myopathies are rare with a frequency of 6 to 10 per million population (223). DM is the most common at all ages, affecting both children and adults and women more than men. PM is usually encountered after the second decade (223). The clinical and serological expression of these myopathies varies considerably according to ethnicity. Pulmonary complications result from both direct and indirect injury, with respiratory muscle dysfunction and ILD, the most frequent specific manifestations (Table 1) (1,2,223,225). Lung involvement is frequent in PM/DM and is increasingly recognized as a frequent source of morbidity and the major cause of mortality (26,226-230). 

Table 3 Main Antibodies Associated with Idiopathic Inflammatory Myopathies s s... 

Troyanov Y, Targoff IN, Tremblay JL, et al. Novel classification of idiopathic inflammatory myopathies based on overlap syndrome features and autoantibodies analysis of 100 French Canadian patients. Medicine (Baltimore) 2005 84 231-249. 

Danko K, Ponyi A, Constantin T, et al. Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features a longitudinal study of 162 cases. Medicine (Baltimore) 2004 83 35-42. 

Yoshifuji H, Fujii T, Kobayashi S, et al. Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies. Autoimmunity 2006 39 233 241. 

Love LA, Leff RL, Fraser DD, et al. A new approach to the classification of idiopathic inflammatory myopathy myositis-specific autoantibodies define useful homogeneous patient groups. Medicine (Baltimore) 1991 70 360-374. 

Selva-O Callaghan A, Labrador-Honillo M, Solans-Laque R, et al. Myositis-specific and myositis-associated antibodies in a series of eighty-eight Mediterranean patients with idiopathic inflammatory myopathy. Arthritis Rheum 2006 55 791-798. 

Englund P, Wahlstrom J, Fathi M, et al. Restricted T cell receptor BV gene usage in the lungs and muscles of patients with idiopathic inflammatory myopathies. Arthritis Rheum 2007 56 372-383. 

PM/DM is an idiopathic inflammatory myopathy however, a number of autoantibody subclassifications correlate with features of clinical disease. When clinical muscle weakness is encountered in the pulmonary clinic, one recent addition to the laboratory armamentarium is the myositis antibody panel. These panels of autoantibody tests can define antibodies to many of the aminoacyl-tRNA synthetases and sometimes help define a CTD when previously not suspected. The most common syndrome is now termed the antisynthetase syndrome when autoantibodies are present in the setting of variable components of fever, myositis, Reynaud s phenomenon, arthritis, mechanic s hands, and ILD (40). Alternative PM/DM diagnostic strategies include targeting muscle weakness with magnetic resonance imaging (MRI) or electromyography (EMG) in preparation for muscle biopsy. It should be noted that some forms of idiopathic myopathy, such as inclusion body myositis, have not been associated with ILD but can present with respiratory impairment due to muscle weakness (41). 

Teixeira A, Cherin P, Demoule A, et al. Diaphragmatic dysfunction in patients with idiopathic inflammatory myopathies. Neuromuscul Disord 2005 15(l) 32-39. 

Hanaoka BY, Peterson CA, Horbinski C, Crofford LJ. Implications of glucocorticoid therapy in idiopathic inflammatory myopathies. Nat Rev Rheumatol 2012 8(8) 448-57. 

Whitaker JN, Engel WK. (1972) Vascular deposits of immunoglobin and complement in idiopathic inflammatory myopathy. New EnglJ Med 286, 333-338. 

Carpenters, KarpatiG, Heller let al. (1978) Inclusion body myositis a distinct variety of idiopathic inflammatory myopathy. Neurology 28, 8-17. 

Tews DS, GoehelHH. (1996) Cytokine expression profiles in idiopathic inflammatory myopathies. J Neuro-pathol Exp Neurol 55, 342-347. 

Fraser DD, Frank JA, Dalakas M et al. (1991) Magnetic resonance imaging in the idiopathic inflammatory myopathies. J Rheumatol 18(11), 1693-1700. 

Phillips BA, Mastaglia FL. (2002) Idiopathic inflammatory myopathies epidemiology, classification and diagnostic criteria. Rheum Dis Clin N Am 28, 723-741. 

Reimers CD, Finkenstaedt M, Witt TN et al (1993) Muscular ultrasound in idiopathic inflammatory myopathies of adults. J Neurol Sci 116 82-92... 

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