Diagnosis, pathogenesis and treatment of myositis: recent advances

Abstract

Dermatomyositis (DM), polymyositis (PM), necrotizing myopathy (NM) and inclusion body myositis (IBM) are four distinct subtypes of idiopathic inflammatory myopathies - in short myositis. Recent studies have shed some light on the unique pathogenesis of each entity. Some of the clinical features are distinct, but muscle biopsy is indispensable for making a reliable diagnosis. The use of magnetic resonance imaging of skeletal muscles and detection of myositis-specific autoantibodies have become useful additions to our diagnostic repertoire. Only few controlled trials are available to substantiate current treatment approaches for myositis and hopes are high that novel modalities will become available within the next few years. In this review we provide an up-to-date overview of the pathogenesis and diagnostic approach of myositis. We aim to present a guide towards therapeutic and general management.

Keywords: muscle immunology/disease; myositis; neuroimmunology.

Figure 1

Therapy of dermatomyositis, polymyositis and necrotizing myopathy. The dose is to be adapted in each individual case; further information within the text. Adapted from [109] with the kind permission of Springer Science and Business Media.