POLYMYOSITIS & DERMATOMYOSITIS |
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GENERAL INFORMATION
DESCRIPTIONThe conditions refer to inflammation of connective tissue, with degenerative changes in the muscles (polymyositis) and the skin (dermatomyositis). This causes weakness and muscle wasting, especially in the arms and legs. This disease has many similarities to rheumatoid arthritis and lupus erythematosus. Body parts involved include the large muscles of the skeleton and the tiny muscles that control small arteries, the skin, and connective tissue. It is twice as common in females as males and can affect all ages.
Appropriate health care includes:
Self-care after diagnosis.
Doctor's treatment.
Hospitalization during early, active phases.
Surgery, if intestinal obstruction occurs.
Time in an extended-care facility for physical therapy and rehabilitation.
SIGNS & SYMPTOMS
Sudden or slow onset of the following:
Weakness in the child's pelvic-girdle and shoulder-girdle muscles.
Skin rash that may itch on the child's face, shoulders, and arms and over the joints.
Cold hands and feet.
Frequent falls and difficulty in getting up.
Speaking or swallowing difficulty.
Infection with fever, muscle weakness, weight loss, and joint pain (sometimes) preceding other symptoms.
CAUSES
Probably a disease of hypersensitivity or autoimmunity, although the cause is uncertain. This disease has been associated with the use of certain drugs and preceding bacterial infections, viral infections, and vaccines.
RISK FACTORS
Allergies.
Use of sulfa drugs, penicillin, antithyroid drugs, gold, and thiazide diuretics.
Family history of hypersensitivity diseases from illness or drugs, such as lupus.
Cancer of the lung, colon, or breast.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies to measure antinuclear antibodies (ANA) and muscle enzymes.
Surgical diagnostic procedures, such as biopsy of muscle and electromyography (See Glossary for both).
POSSIBLE COMPLICATIONS
Muscle and body wasting.
Congestive heart failure.
High blood pressure.
Intestinal obstruction.
Kidney damage.
PROBABLE OUTCOME
The disease may begin suddenly or gradually. Most patients become wheelchair-bound or bedridden because of muscle weakness. Some of your child's symptoms can be controlled briefly with treatment, but the disease is often fatal in a short time. However, remissions or spontaneous recovery can occur -- especially in children. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.
TREATMENT
HOME CARE
The child may need a wheelchair and attendants to help with the daily routine.
If confined to bed, the child should be moved frequently to prevent pressure sores.
Passive exercise should be provided to prevent contractures (muscle shortening).
Cool-water compresses may relieve the child's itching.
MEDICATION
Your doctor may prescribe:
--Cortisone drugs in high doses until acute symptoms diminish, then in lower doses.
--Immunosuppressive drugs, if other treatment is not effective. These drugs impose additional risks to your child, including life-threatening septic bacterial infections.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions, except those imposed by muscle weakness.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms or polymyositis and dermatomyositis.
The following occurs during treatment:
--Blood in the urine.
--Shortness of breath.
--Chest pain.
--Bloody bowel movements.
--Severe abdominal pain.
--Fever.
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