Polymyositis

What is polymyositis?

Polymyositis is an inflammatory disease that occurs very infrequently. In the case of this disease, the patient will feel muscle weakness on both sides of the body.

The person affected by this disease may have difficulty with actions such as climbing stairs, lifting objects, reaching overhead or standing while sitting.

Polymyositis usually affects adults between the ages of 30 and 50. Genetically, it is more common in African-Americans than in whites, and the disease is more prevalent in women than in men.

Prognosis of polymyositis

Polymyositis is a disease without cure, that is, there is no specific treatment that can stop or end this disease, although there are therapies and treatments ranging from the use of drugs with the combination of physiotherapy exercises.

The long-term evolution of the disease is variable. In the first five years of the disease, one in five patients may die, although half of the patients treated have long remissions in these first five years, especially children.

Patients develop severe muscle weakness which progressively affects the muscles. Some of the complications that polymyositis can produce are:

  • Difficulties in swallowing, dysphagia.
  • Aspiration pneumonia
  • Respiratory problems

In turn, there are a number of complications:

  • Calcium deposits in the affected muscles
  • Cancer
  • Heart disease, lung disease or abdominal complications.

In adults, death is primarily caused by cancer and lung disease, although it can be caused by:

  • Malnutrition
  • Pneumonia
  • Severe and prolonged muscle weakness
  • Respiratory failure
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Symptoms of polymyositis

As a systemic disease, polymyositis affects the entire body. It can be said that both muscle weakness and tenderness may be early warning signs of the disease.

Muscle weakness affects the muscles closest to the trunk, such as the hips, thighs, shoulders, arms and neck. Over time, it usually gets progressively worse.

The most common symptoms include:

  • Muscle weakness
  • Muscle pain
  • Difficulty swallowing
  • Voice problems
  • Difficulty working

However, the patient may also experience

  • Fever
  • Fatigue
  • Joint pain
  • Lack of appetite
  • Progressive weight loss

Voice problems are a common symptom in polymyositis.

Medical tests for polymyositis

If the physician or specialist suspects that the patient may have polymyositis, he or she may recommend that one of the following tests be performed:

  • Blood test: with the analysis it will be possible to know the level of muscle enzymes, a factor that indicates damage to the muscles. The test can also detect the presence of specific antibodies associated with various symptoms of the disease, a fact that helps determine the best treatment and medication.
  • Electromyography: This test is based on inserting a fine needle electrode through the skin into the muscle. Electrical activity is measured with muscle contraction and relaxation. Changes in the pattern of electrical activity can confirm whether or not muscle disease is present.
  • MRI: a scanner creates cross-sectional images of the body’s muscles with data generated through magnetic fields and radio waves.
  • Muscle biopsy: a small piece of muscle tissue is removed for analysis in the laboratory. This analysis may show the presence of some abnormalities such as inflammation, lesions…
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What are the causes of polymyositis?

The exact causes of polymyositis are not yet known. Also known as idiopathic inflammatory disease, it is known to share many characteristics with disorders of an autoimmune nature, in which it is the immune system itself that mistakenly attacks the body’s own tissues.

Another frequently made connection regarding the causes has to do with a possible infection.

Can polymyositis be prevented?

At present, there is no known specific way to prevent or avoid the onset of polymyositis.

Treatment for polymyositis

Currently, there is still no specific cure for polymyositis. However, there are ways to prevent or treat the symptoms of the disease. At the same time, treatment can improve both muscle strength and function, and the sooner treatment is started, the better the results will be.

However, it should be noted that there is no single treatment, but that the possibilities vary depending on the symptoms of each patient and how he or she responds to therapy.

  • Medications used to treat polymyositis
    • Corticosteroids: they are very effective in controlling symptoms, but can cause serious long-term side effects. They are the drugs of first choice. Occasionally, prolonged high-dose corticosteroid therapy can cause myopathy. In this case, treatment should be interrupted or reduced by introducing immunosuppressants.
    • Drugs complementary to corticosteroids
    • Rituximab
  • Therapy
    • Physiotherapy: exercises are performed to maintain and strengthen flexibility and strength.
    • Speech therapy: the disease weakens the speech muscles, so they can be strengthened.
    • Nutrition assessment — as the disease progresses, swallowing or chewing becomes more difficult. A dietician can help prepare foods that are easier to eat.
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Which specialist treats polymyositis?

There are several specialists who can treat polymyositis, although the main specialist in charge of the study and treatment of the disease is the rheumatologist, with experience and knowledge in autoimmune and connective tissue diseases.

However, there are several specialists who can help in the treatment of polymyositis, such as a neurologist or an internist. As for complementary therapies, specialists such as a physiotherapist, speech therapist, dietician or nutritionist can help by suggesting exercises to strengthen certain areas or simply giving advice.