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The diagnosis and classification of polymyositis.
[inclusion body myositis]
Polymyositis
is
classified
as
a
separate
entity
among
idiopathic
inflammatory
myopathies
but
it
is
considered
as
the
least
common
since
it
is
an
exclusion
diagnosis
.
This
myopathy
usually
presents
with
subacute-
chronic
symmetric
proximal
limb
weakness
,
although
some
extramuscular
manifestations
are
common
.
Creatine
kinase
values
may
be
increased
up
to
50
-
fold
in
active
disease
.
Muscle
biopsy
is
characterized
by
endomysial
inflammatory
infiltrate
consisting
predominantly
of
CD
8
+
T
cells
that
invade
healthy
muscle
fibres
expressing
the
MHC-
I
antigen
.
Although
serum
autoantibodies
,
EMG
and
imaging
techniques
can
help
in
diagnosis
,
muscle
histopathology
is
a
pivotal
value
.
The
clinical
picture
together
with
the
pathological
findings
confers
the
also
called
PM
pattern
.
A
broad
differential
diagnosis
is
needed
before
concluding
a
diagnosis
of
pure
PM
.
Sporadic
inclusion-body
myositis
,
toxic
,
endocrine
and
metabolic
myopathies
as
well
as
muscular
dystrophies
are
the
major
categories
to
be
ruled
out
.
Finally
,
a
diagnostic
algorithm
for
suspected
cases
of
PM
is
also
proposed
.
Diseases
Validation
Diseases presenting
"subacute-chronic symmetric proximal limb weakness"
symptom
inclusion body myositis
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