THE LUNG IN POLYMYOSITIS
Section snippets
CLINICAL PRESENTATION AND HISTOLOGY
The most obvious clinical feature of PM is a progressive proximal muscle weakness evolving over several weeks to several months. Typically, walking upstairs, brushing one's hair, and getting up from a seated position are acts that are difficult to perform. Mastication or other muscular acts involving facial muscles are usually unaffected.58 Muscle tenderness and myalgias are expected, but severe pain is unusual. Progressive and recurrent disease results in atrophy of the affected muscles and
PULMONARY COMPLICATIONS
The possible causes for pulmonary disease in PM are outlined in the list above. Recurrent aspiration pneumonia is possibly the most frequently encountered pulmonary complication of PM and adds significantly to the morbidity and mortality of this disease because of the development of bacterial pneumonia, lung abscess, and sometimes the acute respiratory distress syndrome.4, 25, 48 Aspiration pneumonia has been reported to occur in 15% to 20% of patients but 40% to 45% report some degree of
TREATMENT OF INTERSTITIAL LUNG DISEASE
In general, response to treatment of ILD depends largely on the underlying histology. In patients with the more cellular forms of ILD (i.e., bronchiolitis obliterans organizing pneumonia, cellular interstitial pneumonia, and pulmonary capillaritis) opposed to those with advanced usual interstitial pneumonitis honeycomb lung and diffuse alveolar damage, there is a response to treatment with corticosteroids alone or in combination with another immunosuppressive agent, such as cyclophosphamide or
References (88)
- et al.
Adverse impact of interstitial fibrosis on prognosis in polymyositis and dermatomyositis
Semin Arthritis Rheum
(1988) - et al.
Pulmonary hypertension in polymyositis
Chest
(1981) - et al.
Anti-JO-1 syndrome presenting as cyptogenic organizing pneumonia
Respir Med
(1995) - et al.
Fibrosing alveolitis in polymyositis: A review of histologically confirmed cases
Am J Med
(1974) - et al.
Cardiac manifestations of polymyositis
Am J Cardiol
(1978) - et al.
Patients with collagen vascular disease and dyspnea: The value of gallium scanning and bronchoalveolar lavage in predicting response to steroid therapy and clinical outcome
Chest
(1987) - et al.
Exercise limitation in patients with polymyositis
Chest
(1990) - et al.
Adult onset polymyositis dermatomyositis: An analysis of clinical and laboratory features and survival in 76 patients and review of the literature
Arthritis Rheum
(1986) - et al.
Presentation, treatment, and prognosis of inflammatory muscle disease in a rural hospital
Am J Med
(1983) - et al.
Dermatomyositis with cystic fibrosis (honeycombing) of the lung
Diseases of the Chest
(1962)
Pulmonary disease in polymyositis/dermatomyositis
Semin Arthritis Rheum
Interstitial pneumonitis in association with polymyositis and dermatomyositis
Chest
Chronic dermatomyositis with intermittent trifascicular block. An electrophysiological conduction system correlation
Chest
The spectrum of polymyositis and dermatomyositis
Med Clin North Am
Dermatomyositis and pulmonary fibrosis associated with anti-JO-1, antibody
J Am Acad Dermatol
Polymyositis heart disease
Chest
Rheumatoid arthritis and cryptogenic organizing pneumonitis
Respir Med
Articular manifestations of polymyositis and dermatomyositis
Am J Med
Polymyositis and interstitial lung disease in a patient with anti JO-1, prototype
Am J Med
Elevated cancer incidence in patients with dermatomyositis: A population based study
J Rheumatol
Cyclophosphamide treatment of interstitial pulmonary fibrosis in polymyositis/dermatomyositis
J Rheumatol
Prognostic factors in polymyositis/dermatomyositis: A computer assisted analysis of 92 cases
Arthritis Rheum
Anti-JO-1 antibody: A marker for myositis with interstitial lung disease
British Journal of Medicine
Maximum static respiratory pressures in generalized neuromuscular disease
American Review of Respiratory Diseases
Polymyositis presenting with respiratory failure
J Neurol Sci
Computed assisted analysis of 153 patients with polymyositis and dermatomyositis
Medicine
Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies
Thorax
Pulmonary hypertension in dermatomyositis
British Heart Journal
Adult respiratory distress syndrome in polymyositis patients with the anti Jo-1 antibody
Arthritis Rheum
A controlled trial of high dose intravenous immune globulin infusions as treatment for dermatomyositis
N Engl J Med
Cardiac involvement in polymyositis
Arthritis Rheum
Chronic pneumomediastinum and subcutaneous emphysema: Association with dermatomyositis
Respiration
Polymyositis: Its presentation, morbidity, and mortality
Brain
Cyclosporin treatment of steroid resistant interstitial pneumonitis associated with dermatomyositis/polymyositis
J Rheumatol
Radiological case of the month
American Journal of the Diseases of Children
Investigation of EB virus and cytomegalovirus in rapidly progressive interstitial pneumonitis in polymyositis/ dermatomyositis by in situ hybridization and polymerase chain reaction
Clin Immunol Immunopathol
Three types of pulmonary involvement in polymyositis
Med Clin North Am
Antibody to JO-1 in polymyositis/dermatomyositis: Association with interstitial pulmonary disease
J Rheumatol
Malignancy associated dermatomyositis with fibrosing alveolitis: Report of a case with a discussion of the management
Clin Exp Dermatol
Bronchiolitis obliterans organizing pneumonia in polymyositis: A case report with long term survival
J Rheumatol
A case of dermatomyositis
JAMA
Cardiac conduction defects in polymyositis
Ann Intern Med
Dermatomyositis in six patients without initial muscle involvement
Arch Dermatol
Bronchiolitis obliterans organizing pneumonia
N Engl J Med
Cited by (0)
Address reprint requests to Marvin I. Schwarz, MD, Division of Pulmonary Sciences and Critical Care Medicine, Box C272, University of Colorado Health Sciences Center, 4200 E. 9th Avenue, Denver, CO 80262
Supported by SCOR Grant #HL27353-04 from the National Heart, Lung and Blood Institute, National Institutes of Health.
- *
Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, Colorado