<scp>SLE</scp> myopathy: a clinicopathological study

Jakati, Saumya; Rajasekhar, Liza; Uppin, Megha S; Challa, Sundaram

doi:10.1111/1756-185x.12592

Cited by 30 publications

(22 citation statements)

References 22 publications

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“…The association of myositis and SLE has been previously explored by several authors [2,15], showing that muscle involvement in SLE patients in the form of diffuse pain or muscular weakness is relatively frequent. A study reported that of 7 SLE patients with myositis, 3 had muscle weakness [15].…”

Section: Discussionmentioning

confidence: 99%

Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study

et al. 2017

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BackgroundThis study aimed to estimate the point prevalence of myositis and identify associated variables of myositis in systemic lupus erythematosus (SLE).Material/MethodsClinical date of patients hospitalized with lupus at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital were collected. Patients were defined as having myositis if they reported the presence of persistent invalidating muscular weakness combined with increased levels of creatine phosphokinase (CPK) and abnormal electromyography (EMG).ResultsThe study sample comprised 1701 lupus patients, of which 44 had myositis. Patients with SLE-associated myositis are more likely to have skin rash, alopecia, pericarditis, vasculitis, anti-Sm, anti-RNP, anti-dsDNA, thrombocytopenia, leukopenia, low C3, low C4, high erythrocyte sedimentation rate (ESR), high D-dimer, and active disease. Multivariate logistic regression found positive associations between leukopenia, alopecia, and active disease with myositis. Negative associations between myositis with the use of corticosteroids or immunosuppressive drugs were revealed in univariate and multivariate analysis.ConclusionsThe point prevalence of myositis was 2.6% in SLE patients. The significant association of alopecia, leukopenia, and active disease with myositis suggests that organ damage, hematological abnormality, and high disease activity promote the progression of myositis in lupus patients.

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Section: Discussionmentioning

confidence: 99%

Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study

et al. 2017

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“…Treatment remains empirical and includes steroids and/or immunosuppressants, intravenous immunoglobulins, biological factors, and rituximab [16]. Diaphragmatic muscle involvement and related weakness may present as ‘shrinking lungs and high sluggish diaphragm with clear lung fields' in lupus occurring mainly in patients without evidence of systemic myopathy [144,145,146,147,148]. In such a clinical context, hypercapnic respiratory failure has occasionally been reported [149].…”

Section: Acute Hypercapnic Respiratory Failure Related To Acute Ventimentioning

confidence: 99%

Acute Respiratory Events in Connective Tissue Disorders

Papiris¹,

Manali²,

Kolilekas³

et al. 2016

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Subacute-acute, hyperacute, or even catastrophic and fulminant respiratory events occur in almost all classic connective tissue disorders (CTDs); they may share systemic life-threatening manifestations, may precipitously lead to respiratory failure requiring ventilatory support as well as a combination of specific therapeutic measures, and in most affected patients constitute the devastating end-of-life event. In CTDs, acute respiratory events may be related to any respiratory compartment including the airways, lung parenchyma, alveolar capillaries, lung vessels, pleura, and ventilatory muscles. Acute respiratory events may also precipitate disease-specific extrapulmonary organ involvement such as aspiration pneumonia and lead to digestive tract involvement and heart-related respiratory events. Finally, antirheumatic drug-related acute respiratory toxicity as well as lung infections related to the rheumatic disease and/or to immunosuppression complete the spectrum of acute respiratory events. Overall, in CTDs the lungs significantly contribute to morbidity and mortality, since they constitute a common site of disease involvement; a major site of infections related to the ‘mater' disease; a major site of drug-related toxicity, and a common site of treatment-related infectious complications. The extreme spectrum of the abovementioned events, as well as the ‘vicious' coexistence of most of the aforementioned manifestations, requires skills, specific diagnostic and therapeutic means, and most of all a multidisciplinary approach of adequately prepared and expert scientists. Avoiding lung disease might represent a major concern for future advancements in the treatment of autoimmune disorders.

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“…Clinical evidence of myositis was present in 8.8% of SLE patients in registry. [19] Two patients of dengue fever who showed spontaneous activity underwent biopsy. Both of them had normal study.…”

Section: Discussionmentioning

confidence: 99%

A study of acute muscle dysfunction with particular reference to dengue myopathy

Verma

Holla

Kumar

et al. 2017

Ann Indian Acad Neurol

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Background:Acute myopathy is a common cause of acute motor quadriparesis which has various etiologies with different courses of illness and prognosis depending on the cause. Understanding this diversity helps us in proper approach toward diagnosis, predicting the prognosis, and possible complications and in improving the treatments that are being provided. This study was planned to study the clinical, electrophysiological, and etiological profile of patients presenting with acute myopathy. We also studied how dengue-related acute myopathy differs from other causes and also difference between myopathy due to myositis and hypokalemia in cases of dengue.Materials and Methods:This was a prospective, observational study involving all clinically suspected cases of acute myopathy of not more than 4 weeks duration with raised serum creatine kinase (CK) level. They were subjected to detailed clinical evaluation along with hematological, biochemical, microbiological, and electrophysiological studies and followed-up for outcome at 1 and 3 months. Muscle biopsy and histopathological examination were done in selected patients after taking informed consent. Statistical analysis was performed by appropriate methods using SPSS version 16.0 (Chicago, IL, USA).Results:We evaluated thirty patients of acute myopathy with raised CK level. Seventeen patients had fever, 11 had myalgia, and 5 had skin lesions. All presented with symmetric weakness, 17 (56.7%) patients having predominantly proximal weakness, neck or truncal weakness in 6 (20%), hyporeflexia in 12 (40%), with mean Medical Research Council (MRC) sum score of 46.67 ± 6.0. Eight (mean modified Barthel index [MBI] at presentation - 15 ± 3.7) patients had poor functional status according to MBI and 15 according to modified Rankin scale (MRS) (mean MRS score - 2.5 ± 1.2). Etiology was dengue viral infection in 14 patients; hypokalemia due to various causes other than dengue in 8; pyomyositis in 3; dermatomyositis, polymyositis, thyrotoxicosis, systemic lupus erythematosus, and unknown etiology in one each. Only eight patients had abnormal electrophysiology and seven among nine biopsies done were abnormal. At 1 month, 24 (80.0%) and 23 (76.7%) patients had achieved normal MBI and MRS scores with 28 (93.3) and 27 (90%) patients, respectively, at 3 months. Dengue with hypokalemia had less myalgia, more of hyporeflexia, and lower serum CK compared to those without hypokalemia.Conclusion:Dengue infection and hypokalemia due to various causes are the most common causes of acute myopathy and are associated with rapid and complete recovery within 1 month. Shorter duration of illness, higher MRC sum score, better disability status at presentation, lower serum CK correlate with better outcome. Biopsy was decisive in <20% cases; hence, it is not primary investigation in acute myopathy.

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SLE myopathy: a clinicopathological study

Cited by 30 publications

References 22 publications

Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study

Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study

Acute Respiratory Events in Connective Tissue Disorders

A study of acute muscle dysfunction with particular reference to dengue myopathy

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