Autoimmune muscle disease

Andrew Mammen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Patients with polymyositis (PM), dermatomyositis (DM), and immune-mediated necrotizing myopathy (IMNM) present with the subacute onset of symmetric proximal muscle weakness, elevated muscle enzymes, myopathic findings on electromyography, and autoantibodies. DM patients are distinguished by their cutaneous manifestations. Characteristic features on muscle biopsy include the invasion of nonnecrotic muscle fibers by T cells in PM, perifascicular atrophy in DM, and myofiber necrosis without prominent inflammation in IMNM. Importantly, these are regarded as autoimmune diseases and most patients respond partially, if not completely, to immunosuppressive therapy.Patients with inclusion body myositis (IBM) usually present with the insidious onset of asymmetric weakness in distal muscles (e.g., wrist flexors, and distal finger flexors), often when more proximal muscle groups are relatively preserved. Although IBM muscle biopsies usually have focal invasion of myofibers by lymphocytes, the majority of IBM biopsies also include rimmed vacuoles. While most IBM patients do have autoantibodies, treatment with immunosuppressive agents does not improve their clinical course. Along with the presence of abnormally aggregated proteins on muscle biopsy, the refractory nature and relentless course of IBM suggest that the underlying pathophysiology may include a dominant myodegenerative component.This chapter will focus on the epidemiology, clinical presentation, and treatment of the autoimmune myopathies and IBM. An emphasis will be placed on recent advances, indicating that these are a diverse family of diseases and that each of more than a dozen myositis autoantibodies is associated with a distinct clinical phenotype.

Original languageEnglish (US)
Title of host publicationAutoimmune Neurology, 2016
PublisherElsevier
Pages467-484
Number of pages18
Volume133
ISBN (Print)9780444634320
DOIs
StatePublished - 2016
Externally publishedYes

Publication series

NameHandbook of Clinical Neurology
Volume133
ISSN (Print)00729752
ISSN (Electronic)22124152

Fingerprint

Inclusion Body Myositis
Autoimmune Diseases
Muscles
Dermatomyositis
Muscular Diseases
Autoantibodies
Biopsy
Immunosuppressive Agents
Skin Manifestations
Polymyositis
Myositis
Muscle Proteins
Muscle Weakness
Electromyography
Vacuoles
Wrist
Fingers
Atrophy
Epidemiology
Necrosis

Keywords

  • Autoantibododies
  • Autoimmune myopathy
  • Dermatomyositis
  • Immune-mediated necrotizing myopathy
  • Inclusion body myositis
  • Myositis
  • Polymyositis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Mammen, A. (2016). Autoimmune muscle disease. In Autoimmune Neurology, 2016 (Vol. 133, pp. 467-484). (Handbook of Clinical Neurology; Vol. 133). Elsevier. https://doi.org/10.1016/B978-0-444-63432-0.00025-6

Autoimmune muscle disease. / Mammen, Andrew.

Autoimmune Neurology, 2016. Vol. 133 Elsevier, 2016. p. 467-484 (Handbook of Clinical Neurology; Vol. 133).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Mammen, A 2016, Autoimmune muscle disease. in Autoimmune Neurology, 2016. vol. 133, Handbook of Clinical Neurology, vol. 133, Elsevier, pp. 467-484. https://doi.org/10.1016/B978-0-444-63432-0.00025-6
Mammen A. Autoimmune muscle disease. In Autoimmune Neurology, 2016. Vol. 133. Elsevier. 2016. p. 467-484. (Handbook of Clinical Neurology). https://doi.org/10.1016/B978-0-444-63432-0.00025-6
Mammen, Andrew. / Autoimmune muscle disease. Autoimmune Neurology, 2016. Vol. 133 Elsevier, 2016. pp. 467-484 (Handbook of Clinical Neurology).
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