RESUMO
Idiopathic inflammatory myopathies are rare autoimmune diseases with inflammatory lesions in skeletal muscles. They include polymyositis, dermatomyositis, juvenile myositis and inclusion body myositis. These are clinically and immunologically heterogeneous conditions differently responding to therapy. The authors consider the main manifestations of polymyositis/dermatomyositis and principal differences between them. Therapy is based on the prescription of glucocorticoids in combination with immunesuppressors. Better understanding immunological, genetic, and molecular mechanisms opens up new prospects for the management of idiopathic inflammatory myopathies.
Assuntos
Variação Antigênica/imunologia , Miosite/imunologia , Miosite/patologia , Dermatomiosite/diagnóstico , Dermatomiosite/patologia , Dermatomiosite/terapia , Humanos , Inflamação/imunologia , Inflamação/patologia , Inflamação/terapia , Miosite/terapia , Polimiosite/diagnóstico , Polimiosite/patologia , Polimiosite/terapiaRESUMO
Antisynthetase syndrome encompassing a symptom complex with severe interstitial lung disease is the severest subtype of polymyositis and dermatomyositis. The characteristic feature of antisynthetase syndrome is the insufficient efficiency of traditional therapy with glucocorticosteroids and cytostatics, which determines the prognosis of the disease and the need for new therapeutic approaches to treating these patients.
Assuntos
Anticorpos Monoclonais Murinos , Dermatomiosite/complicações , Miosite , Anticorpos Monoclonais Murinos/administração & dosagem , Anticorpos Monoclonais Murinos/efeitos adversos , Anticorpos Monoclonais Murinos/imunologia , Antígenos CD20/análise , Terapia Baseada em Transplante de Células e Tecidos/métodos , Dermatomiosite/imunologia , Monitoramento de Medicamentos , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/efeitos adversos , Fatores Imunológicos/imunologia , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/fisiopatologia , Monitorização Imunológica , Miosite/etiologia , Miosite/imunologia , Miosite/fisiopatologia , Miosite/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Rituximab , Resultado do TratamentoRESUMO
The study was undertaken to examine the impact of glucocorticoid therapy (GCT) on mineral bone density (MBD) in patients with idiopathic inflammatory myopathies. Double-energy X-ray absorptiometry was used to determine MBD of the vertebral column and proximal femur in 42 females (30 with the preserved menstrual cycle (PMC), 12 in postmenopause (PMP) with polymyositis/dermatomyositis (PM/DM). All the patients received GCT. A random population sample including 106 females aged 20 to 69 years formed a control group. MBD of the neck of the femur was significantly lower in patients from all age groups, in the lumbar vertebral column in young (20-29 years) and old (over 50 years) females than in the controls. The development of osteoporosis (OP) was more frequently observed in PMP females: OP in the lumbar spine was in 16.7 and 66.7% of the PMC and PMP females, respectively; that in the neck of the femur was in 11 and 33%. There was no relationship between MBD and the specific features of GCT, namely the duration, cumulative dose, and the maximum dose. There was a reduction in MBD in patients with PM/DM on GCT in all age groups, more frequently in PMP patients.
