Skip to main content

Advertisement

SpringerLink
Log in

Polymyositis, a very uncommon isolated disease: clinical and histological re-evaluation after long-term follow-up

  • Original Article - Cases with a Message
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of the present study was to explore whether polymyositis may be considered as an isolated, organ-specific disease or more suitably as a secondary or associated entity. A retrospective re-evaluation of all the muscle biopsies performed at the Hospital Clínic of Barcelona showing histopathological pattern of polymyositis from January 1997 to May 2012 was carried out. The medical records of the patients with the aforementioned pathological pattern were also reviewed. From 1.290 muscle biopsies performed during the period evaluated, 36 with polymyositis pattern were identified. At the time of muscle biopsy, polymyositis pattern was secondary or associated with other disease in 26 patients and was classified as isolated in the remaining ten patients. After pathological re-evaluation and long-term clinical follow-up, only one patient remained with this diagnosis. Overall, the main final diagnosis related to the initial polymyositis pattern was inflammatory myopathy associated with connective tissue disease. Several other associated conditions were also identified. Isolated polymyositis is highly uncommon. Ruling out potential associated or confusing entities, like inclusion body myositis, overlap syndromes, infections, and cancer, is mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Milisenda JC, Selva-´Callaghan A, Grau JM (2014) The diagnosis and classification of polymyositis. J Autoimmun 48–49:118–121

    Article  PubMed  Google Scholar 

  2. Amato AA, Griggs RC (2003) Unicorns, drag dragons, polymyositis and other mythological beasts. Neurology 61:288–290

    Article  PubMed  Google Scholar 

  3. Van Der Meulen MFG, Bronner IM, Hoogendijk JE et al (2003) Polymyositis: an overdiagnosed entity. Neurology 61:316–321

    Article  PubMed  Google Scholar 

  4. Kissel JT (2008) Polymyositis: not a unicorn or mythological beast…but maybe a duck ? Neurology 70:414–415

    Article  PubMed  Google Scholar 

  5. Chahin N, Engel (2008) Correlation of muscle biopsy, clinical course, and outcome in PM and sporadic IBM. Neurology 70:418–424

    Article  PubMed  Google Scholar 

  6. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis : first of two parts. N Engl J Med 292:344–347

    Article  CAS  PubMed  Google Scholar 

  7. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis : second of two parts. N Engl J Med 292:403–407

    Article  CAS  PubMed  Google Scholar 

  8. Heckmann JM, Pillay K, Hearn AP, Kenyon C (2010) Polymyositis in HIV-infected subjects. Neuromuscul Disord 20:735–739

    Article  CAS  PubMed  Google Scholar 

  9. Aydintug A, Cervera R, D´Cruz D, Rammírez G et al (1991) Polymyositis complicating D-penicillamine treatment. Postgrad Med 67:1018–1020

    Article  CAS  Google Scholar 

  10. Ishikawa Y, Yukawa N, Ohmura K et al (2009) Etanercept-induced anti-Jo-1-antibody-positive polymyositis in a patient with rheumatoid arthritis:a case report and review of literature. Clin Rheumatol 29:563–566

    Article  Google Scholar 

  11. Vint J, Samson M, Galtier JN et al (2010) Dysferlin deficiency treated like refractory polymyositis. Clin Rheumatol 29:103–106

    Article  Google Scholar 

  12. Chapin JE, Kornfeld M, Harris A (2005) Amyloid myopathy: characteristic features of a still underdiagnosed disease. Muscle Nerve 31:266–272

    Article  PubMed  Google Scholar 

  13. Tang YC, Wang SK, Yuan WL, Tang YC, Wang SK (2011) Primary aldosteronism simulating polymyositis. J Rheumatol 38:1529–1533

    Article  PubMed  Google Scholar 

  14. Yunis EJ, Samaha FJ (1971) Inclusion body myositis. Lab Invest 25:240–248

    CAS  PubMed  Google Scholar 

  15. Milisenda JC, Prieto-Gonzáles S, Grau JM (2012) Sporadic inclusion body myositis. Semin Fund Esp Reumatol 13:23–30

    Article  Google Scholar 

  16. Miller T, Al-Tozi MT, Lopate G, Pestronk A (2002) Myopathy with antibodies to signal recognition particle: clinical and pathological features. J Neurol Neurosurg Psichiatr 73:420–428

    Article  CAS  Google Scholar 

  17. Vargas-Leguás H, Selva-O´Callaghan A, Campins-Martí M et al (2007) Polymyositis-dermatomyositis: incidence in Spain (1997–2004). Med Clin (Barc) 129:721–724

    Article  Google Scholar 

  18. Prieto S, Grau JM (2010) The geoepidemiology of autoimmune muscle disease. Autoimmun Rev 9:A330–A334

    Article  PubMed  Google Scholar 

  19. TroyanovY Tragoff I, Tremblay JL, Goulet JR, Raymond Y, Senécal JL (2005) Novel classification of idiopathic inflammatory myositis based on overlap syndrome features and autoantibodies. Analysis of 100 French–Canadian patients. Medicine (Baltimore) 84:231–249

    Article  Google Scholar 

  20. D´Arcy CE, Ryan MM, McLean CA (2009) Juvenile polymyositis or paediatric muscle dystrophy: a detailed re-analysis of 13 cases. Hystopathology 55:452–462

    Article  Google Scholar 

  21. Fernandez C, Bardin N, De Paula AM, Salort-Campana E, Beyamine A, Franques J et al (2013) Correlation of clinicoserologic and pathologic classifications on inflammatory myopathies. Medicine (Baltimore) 92:15–24

    Article  Google Scholar 

  22. Carpenter S, Karpati G (2001) Pathology of skeletal muscle, 2nd edn., Oxford University Press, Oxford, ISBN: 0-19506364-3

  23. Dalakas M, Hohfeld R (2003) Polymyositis and dermatomyositis. Lancet 362:971–982

    Article  CAS  PubMed  Google Scholar 

  24. Griggs RC, Askanas V, Di Mauro S, Engel A, Karpati G, Mendell G et al (1995) Inclusion body myositis. Ann Neurol 38:705–713

    Article  CAS  PubMed  Google Scholar 

  25. Averbuch Heller L, Steiner I, Abramsky O (1992) Neurologic manifestations of progressive systemic sclerosis. Arch Neurol 49:1292–1295

  26. Clements PJ, Furst DE, Campion DS et al (1978) Muscle disease in progressive systemic sclerosis: diagnostic and therapeutic considerations. Arhtritis Rheum 21:62–71

    Article  CAS  Google Scholar 

  27. Ranque B, Authier F-J, Le-Guern V et al (2009) A descriptive and prognostic study of systemic sclerosis-associated myopathies. Ann Rheum Dis 68:1474–1477

    Article  CAS  PubMed  Google Scholar 

  28. Meyer A, Meyer N, Schaeffer M, Gottemberg JE, Geny B, Sibilia J (2014) Incidence and prevalence of idiopathic myopathies: a systematic review. Rheumatology 26:261–275

    Google Scholar 

  29. Tan JA, Roberts-Thompson PJ, Blumbergs P, Hakendorf P, Cox SR, Limaye V (2013) Incidence and prevalence of idiopathic inflammatory myopathies in South Australia: a 30 years epidemiologic study of biopsy proven cases. Int J Rheum Dis 16:331–338

    Article  PubMed  Google Scholar 

  30. Linklater H, Pipetone N, Rose MR et al (2013) Classifying idiopathic inflammatory myopathies: comparing the performance of six existing criteria. Clin Exp Rheumtol 31:767–769

    Google Scholar 

Download references

Conflict of interest

The authors declare no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Hospital Universitário Pedro Ernesto, State University of Rio de Janeiro, Boulevard. 28 de Setembro 77, Rheumatology discipline, Rio de Janeiro, 20551-031, Brazil

      Veronica Silva Vilela

    2. Department of Internal Medicine, Hospital Clínic, University of Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Catalonia, Spain

      Veronica Silva Vilela, José C. Milisenda & Josep M. Grau

    3. Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Catalonia, Spain

      Sergio Prieto-González

    4. Department of Internal Medicine, Hospital Vall d´Hebron, Passeig Vall d´Hebron, 119-129, 08035, Barcelona, Catalonia, Spain

      Albert Selva-O´Callaghan

    Authors
    1. Veronica Silva Vilela
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Sergio Prieto-González
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. José C. Milisenda
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Albert Selva-O´Callaghan
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Josep M. Grau
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Veronica Silva Vilela.

    Additional information

    Veronica Silva Vilela and Sergio Prieto-González contributed equally to this article.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Vilela, V.S., Prieto-González, S., Milisenda, J.C. et al. Polymyositis, a very uncommon isolated disease: clinical and histological re-evaluation after long-term follow-up. Rheumatol Int 35, 915–920 (2015). https://doi.org/10.1007/s00296-014-3198-5

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00296-014-3198-5

    Keywords

    Search

    Navigation