Inflammatory Muscle Disease: A New Landscape.
Fiche publication
Date publication
mars 2017
Journal
Joint, bone, spine : revue du rhumatisme
Auteurs
Membres identifiés du Cancéropôle Est :
Pr LIPSKER Dan, Pr GOTTENBERG Jacques-Eric, Pr MARTIN Thierry, Pr GENY Bernard
Tous les auteurs :
Meyer A, Lannes B, Goetz J, Echaniz-Laguna A, Lipsker D, Arnaud L, Martin T, Gottenberg JE, Geny B, Sibilia J
Lien Pubmed
Résumé
Greater accuracy in clinical descriptions combined with advances in muscle histology and immunology have established that inflammatory muscle diseases (IMDs) resemble inflammatory joint diseases in that they constitute a highly heterogeneous group of conditions. The topographic distribution, severity, and tempo of onset vary widely, and the histological findings distinguish at least five different profiles, which may reflect different pathophysiological processes. Most IMDs are connective tissue diseases that can affect multiple organs, among which the most common targets are the skin, joints, and lungs. The extramuscular manifestations may antedate the muscular involvement and should therefore suggest a diagnosis of IMD even in the absence of obvious muscle disease. About 20 different autoantibodies have been identified in patients with IMD. Some are mutually exclusive and associated with specific combinations of clinical manifestations. Following the model of antisynthetase syndrome, about 10 syndromes associated with autoantibodies specific of IMD have been identified. Thus, polymyositis is now emerging as a rare entity that is often mistaken for more recently described patterns of IMD. No consensus exists to date about the classification of IMDs. Nevertheless, the clinical manifestations, autoantibody profile, and muscle histology can be used to distinguish patient subgroups with fairly homogeneous patterns of complications, treatment responses, and outcomes. These subgroups are also characterized by specific genetic and environmental factors. The advances made in the nosology of IMDs have benefited the diagnosis, personalization of treatment strategies, and understanding of pathophysiological mechanisms. They can be expected to assist in the development of specific treatments.
Mots clés
Dermatomyositis, Inclusion body myopathies, Inclusion body myositis, Inflammatory muscle disease, Myositis, Necrotizing autoimmune myositis
Référence
Joint Bone Spine. 2017 Mar;: