Analysis of muscular pathological features in different types of connective tissue diseases / 中华风湿病学杂志

ABSTRACT

Objective To explore muscular pathological features in 6 types of connective tissue diseases except polymyositis and dermatomyositis.Methods We collected 53 patients who were diagnosed as connective tissue diseases with mnscle involvement and were performed muscle biopsies in our department from January,2010 to December,2016.The myopathological features were analyzed.Results Fifty-three cases including 6 systemic sclerosis cases,12 systemic lupus erythematosus cases,7 rheumatoid arthritis cases,13 Sj(o)gren's syndrome (SS) cases,5 mixed connective tissue disease cases,l0 overlap syndrome cases.Thirtyfive out of 53(66％)cases were in accordance with inflammatory myopathies changes.The main histopathologic categories were necrotizing myopathy (3/4) in systemic sclerosis,nonspecific myositis (4/5) in systemic lupus erythematosus,nonspecific myositis (4/9) and necrotizing myopathy (3/9) in SS,nonspecific myositis and necrotizing myopathy (3/8) in overlap syndrome.The most common pathological features were muscle fiber atrophy (50/53,94％),microangiopathy (40/53,75％),myofiber necrosis/regeneration (36/53,68％),C5b-9 deposits in sarcolemma (30/48,63％),diffuse major histocompatibility complex (MHC)-Ⅰ expressing in sarcolemma and endochylema area within myofibers (27/52,52％).Conclusion Necrotizing myopathy and nonspecific myositis are the most common histo-pathological categories in connective tissue diseases except polymyositis and der-matomyositis.Muscle fiber atrophy,microangiopathy,and necrosis/regeneration are the most prevalent pathologic features.