| Abstract [eng] |
Introduction: Idiopathic inflammatory myopathies such as dermatomyositis, polymyositis, autoimmune necrotizing myositis, myositis of inclusion bodies, etc. are rare diseases. In their presence of clinical signs: increased creatine kinase, specific changes in muscle biopsy, myositis-specific antibodies should be tested to clarify the diagnosis. Description of clinical cases: Two clinical cases are presented. First clinical case: A 53-year-old patient with primary dermatomyositis. Skin lesions characteristic of dermatomyositis in addition to typical clinical symptoms, but no increase in creatine kinase and myoglobin were observed during the course of the disease. Positive antinuclear and anti-Ro-52 antibodies that are associated with the development of interstitial lung disease and arthritis have been found. Case 2: A 60-year-old patient with proximal limb muscle weakness, difficulty in swallowing solid food, and persistent high levels of creatine kinase and myoglobin during the course of the treatment. Positive antibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) were found, and statin-associated polymyositis was confirmed. Literature review and summary: Using PubMed, MEDLINE databases, using the MeSH glossary, a review of the literature was performed, in which the clinical incidence and diagnostic differences between different myositis-induced muscle lesions were analyzed by reviewing clinical cases and literature data. Conclusions and Suggestions: Isolated elevated creatine kinase is an insufficient criterion for the detection of muscle damage, any diagnosis of any myopathy should be based on additional diagnostic tests for muscle damage (autoantibodies, histology, ENMG). Myositis-specific antibodies and myositis-associated antibodies are associated with their characteristic combinations of systemic and skin phenotypes, the recognition of which helps diagnose myositis while identifying its subtype. |
