Polymyositis 多發性肌炎
- 侵犯肌肉為主, 無力
- CD8 T cell mediated
- Systemic involvement :
Interstitial lung disease
Cardiac ( HF, Conduction abnormalities )
Dermatomyositis 皮肌炎
- 侵犯肌肉 + 皮膚
- Immune complex deposition in blood vessel
- 手指關節處背部有 Gottron papules
- Erythematous rash : 眼皮, 前額, 雙頰, 胸前的 V 字區及後頸
- Photosensitivity
- 指甲周圍有紅斑
- 毛細血管擴張
Inclusion body myositis 包涵體肌炎
對治療效果較差
較 asymmetric, distal
Symmetric weakness that progresses over weeks to months
Weakness of the proximal limbs, trunk, and neck.
Some experience dysphagia, myalgias,
and rarely dyspnea when the respiratory muscles involved.
Sensation and reflexes are normal,
and the ocular muscles are usually spared.
Occasionally cardiac muscle may be involved :
Cardiomyopathy, heart failure, and conduction disturbances.
Both polymyositis and dermatomyositis require treatment with
systemic corticosteroids or other immunosuppressants
- 急性或慢性對稱性兩側近端肌肉無力或合併疼痛感
尤其是上臂, 肩胛肌或大腿肌肉無力
-1/3 合併有 esophageal muscle involvement, 導致 Dysphagia
- 有合併 malignancy 的機率, 東方人考慮 NPC
年紀大之病人務必要定期檢查是否有腫瘤發生
* Increased risk of cancer :
- Older age, age greater than 45
- Male sex
- Dysphagia
- Cutaneous necrosis, cutaneous vasculitis
- Rapid onset of myositis (<4 weeks)
- Elevated CK, Higher ESR, Higher CRP levels
- 都是 女 > 男
- PM / DM : onset 40-50 y/o, DM 也可能 childhood
- IBM : onset > 50 y/o
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