The inflammatory myopathies

Beschreibung

paeds-neurology Mindmap am The inflammatory myopathies, erstellt von v.djabatey am 12/01/2014.
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Zusammenfassung der Ressource

The inflammatory myopathies
  1. benign acute myositis
    1. assumed post-viral phenomenon
      1. often follows an upper resp tract infection
        1. runs a self-limiting course
      2. pain & weakness in the affected mm
        1. CPK usually raised
        2. dermatomyositis
          1. systemic illness
            1. probably due to an angiopathy
            2. onset 5-10 years old
              1. acute
                1. typically insidious
                  1. fever
                    1. misery
                      1. eventually symmetrical mm weakness
                        1. mainly proximal
                        2. pharyngeal mm involvement
                          1. swallowing affected
                          2. heliotrope (violaceous) rash
                            1. characteristic
                              1. eyelids
                                1. extensor surfaces of e.g.
                                  1. elbow
                                2. periorbital oedema
                                  1. subcutaneous calcification
                                3. Ix
                                  1. raised ESR, CRP possibly
                                    1. muscle biopsy
                                      1. inflammatory cell infiltrate & atrophy
                                    2. Mx
                                      1. physiotherapy
                                        1. prevent contractures
                                        2. corticosteroids
                                          1. mainstay of Rx
                                            1. continue @ tailored dose for 2 years
                                            2. immunosuppressants
                                              1. methotrexate
                                                1. ciclosporin
                                              2. mortality= 5-10%
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