Diffuse

Polymyositis Evaluation

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Polymyositis Evaluation, Dermatomyositis Evaluation

  • Labs
  • Muscle Enzymes
  1. Serum Aldolase
  2. Alanine Aminotransferase (ALT)
  3. Aspartate Aminotransferase (AST)
  4. Lactate Dehydrogenase (LDH)
  5. Creatine Phosphokinase (CPK)
  6. Carbonic Anhydrase (isoenzyme III)
    1. Limited availability
  • Lab
  • Rheumatologic
  1. Erythrocyte Sedimentation Rate (ESR)
    1. Increased in 50% of cases
    2. Poor correlation with disease activity
  2. Rheumatoid Factor
    1. Increased in 20% of cases
    2. Associated with overlap syndrome
  3. Antinuclear Antibody (ANA)
    1. Seen in 80% of Dermatomyositis and Polymyositis patients
  • Labs
  • Specific Autoantibodies
  1. Anti-Jo1
    1. Seen in 20% of Dermatomyositis
  2. Anti-EJ
    1. Associated with Dermatomyositis
  3. Signal Recognition Particle (SRP)
    1. Seen in 5% of Polymyositis
    2. Associated in severe, acute-onset Polymyositis
      1. Treatment resistant Dermatomyositis, Polymyositis
      2. Associated with cardiac involvement
  4. Anti-Mi2
    1. Seen in 15-20% of classic Dermatomyositis
    2. Associated conditions
      1. Treatment-responsive form
      2. Shawl sign in Dermatomyositis
      3. Prominent cuticular changes
  5. Anti-PM-Scl
    1. Seen in overlap syndrome
    2. Associated conditions
      1. Dermatomyositis and Polymyositis
      2. Scleroderma
  6. Anti-Ku
    1. Seen in overlap syndrome
    2. Associated conditions
      1. Dermatomyositis and Polymyositis
      2. Scleroderma
      3. Systemic Lupus Erythematosus
  1. Neopterin
  2. Factor VIII-related Antigen (Von Willebrand Factor)
  1. False negative in 10% of cases
  2. Myopathic or myogenic pattern
    1. Short duration, polyphasic motor unit potentials
    2. Spontaneous fibrillation potentials
  1. Initial gynecologic exam and every 6-12 months x2 years
  2. Baseline CA-125 level
  3. Baseline Mammogram
  4. Baseline Transvaginal Ultrasound of the ovaries