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diagnosis rheumatology differential dermatology autoimmune clinical photo antimda5 antimda5dm antinxp2 antinxp2dm ck comparison creatine elevated gottrons gottronspapules heliotroperash kinase management
Autoimmune Myositis Necrotizing myopathy is associated with higher CK levels, greater level of muscle weakness, less systemic
Autoimmune Myositis ... Necrotizing myopathy ... Dermatomyositis ... including heliotrope ... and anti-HMGCR myopathy
Myositis and Myopathies Polymyositis • Progressive, symmetric muscle weakness • Elevated CK, +Anti-Jo, +Anti-Mi2 Dermatomyositis
Myositis and Myopathies ... Anti-Jo, +Anti-Mi2 Dermatomyositis ... muscle weakness, rash ... Inclusion Body Myositis ... , +Anti-dsDNA, Myositis
Dermatomyositis A middle-aged man describes progressive difficulty combing his hair and rising from a seated position over
Dermatomyositis ... This is a case of ... , with: 1) heliotrope ... rash, 2) shawl ... usually indicates myopathy
Creatine Kinase - Causes of Elevated CK Levels Acute CK Elevation (Pain > Weakness): • RHABDOMYOLYSIS
Creatine Kinase - Causes ... Critical Illness Myopathy ... Subacute to Chronic Causes ... : dermatomyositis ... Inclusion body myositis
Dermatomyositis with heliotrope rash, shawl sign, and Gottron's papules A middle-aged man describes progressive difficulty combing his
Dermatomyositis ... with heliotrope ... rash, shawl sign ... out this is a case ... usually indicates myopathy
Causes of Neuromuscular Weakness • Spinal Cord: Demyelinating Disease (MS), Epidural abscess, Infarction, Syringomyelia, Tetanus, Transverse
Causes of Neuromuscular ... Tetanus, Transverse Myelitis ... Mitochondrial myopathy ... , Polymyositis/dermatomyositis ... Neuromuscular #Weakness #Causes
ANTI-MDA5 DERMATOMYOSITIS Cutaneous manifestations: • Periorbital heliotrope (blue-purple) rash with edema • Erythematous rash on the face, or the
ANTI-MDA5 DERMATOMYOSITIS ... • Periorbital heliotrope ... (blue-purple) rash ... • Erythematous rash ... Men • ~50% of cases
Autoimmune Myositis - Differential Diagnosis Framework Inflammatory Myopathies: Commonly symmetric proximal muscle weakness, no substantial muscle pain
Autoimmune Myositis ... Symptoms: • Gottron rash ... Shawl sign • Heliotrope ... INCLUSION BODY MYOSITIS ... statins - probably caused
Anti-NXP-2 Dermatomyositis What? DM with generalized subcutaneous edema Pts have more myalgias, more severe weakness, and an increased prevalence
Anti-NXP-2 Dermatomyositis ... • Periorbital heliotrope ... (blue-purple) rash ... • Erythematous rash ... Muscle atrophy may cause
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