Display options
Cite
Karri SB, Kannan MA, Rajashekhar L, et al. Clinico pathological study of adult dermatomyositis: Importance of muscle histology in the diagnosis. Ann Indian Acad Neurol. 2015;18(2):194-9doi: 10.4103/0972-2327.150603.
Karri, S. B., Kannan, M. A., Rajashekhar, L., Uppin, M. S., & Challa, S. (2015). Clinico pathological study of adult dermatomyositis: Importance of muscle histology in the diagnosis. Annals of Indian Academy of Neurology, 18(2), 194-9. https://doi.org/10.4103/0972-2327.150603
Karri, Sudhir Babu, et al. "Clinico pathological study of adult dermatomyositis: Importance of muscle histology in the diagnosis." Annals of Indian Academy of Neurology vol. 18,2 (2015): 194-9. doi: https://doi.org/10.4103/0972-2327.150603
Karri SB, Kannan MA, Rajashekhar L, Uppin MS, Challa S. Clinico pathological study of adult dermatomyositis: Importance of muscle histology in the diagnosis. Ann Indian Acad Neurol. 2015 Apr-Jun;18(2):194-9. doi: 10.4103/0972-2327.150603. PMID: 26019418; PMCID: PMC4445196.
Copy Download .nbib Format: NLM
Share it on

Ann Indian Acad Neurol. 2015 Apr-Jun;18(2):194-9. doi: 10.4103/0972-2327.150603.

Clinico pathological study of adult dermatomyositis: Importance of muscle histology in the diagnosis.

Annals of Indian Academy of Neurology

Sudhir Babu Karri, Meena Anga Muthu Kannan, Liza Rajashekhar, Megha S Uppin, Sundaram Challa

Affiliations

  1. Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
  2. Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
  3. Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

PMID: 26019418 PMCID: PMC4445196 DOI: 10.4103/0972-2327.150603

Abstract

AIMS: To study the histological features on muscle biopsy and correlate them with clinical features, other laboratory data in adult patients to make a diagnosis of dermatomyositis (DM), applying the European Neuromuscular center (ENMC) criteria.

MATERIALS AND METHODS: Adult patients who fulfilled clinical, laboratory, and muscle biopsy findings according to ENMC criteria for DM during the period 2010-2013 were included in the study. Cryostat sections of muscle biopsy were reviewed with emphasis on Perifascicular atrophy (PFA), perivascular/endomysial inflammation. Muscular dystrophies and metabolic myopathies were excluded by appropriate immunohistochemistry and special stains.

RESULTS: The diagnosis of adult DM was made in 45 patients out of 170 clinically suspected idiopathic inflammatory myopathies. These included 33 definite, 4 probable, 7 possible sine dermatitis, and 1 amyopathic DM. All patients with definite DM had typical rash and proximal muscle weakness and muscle biopsy showed PFA with or without inflammation. Thirteen patients had quadriparesis, neck muscle weakness, dysphagia/dysphonia at presentation. Patients with probable DM had rash and showed perivascular/endomysial inflammation with no PFA. Possible DM sine dermatitis showed PFA with perivascular/endomysial infiltrates. One patient of amyopathic DM had typical heliotrope rash and characteristic skin biopsy.

CONCLUSIONS: Histological features are important for the diagnosis of DM. Relying on PFA for diagnosis of definite DM underestimates the true frequency of DM.

Keywords: Dermatomyositis; perifascicular atrophy; perivascular inflammation

References

  1. J Am Acad Dermatol. 2006 Apr;54(4):597-613 - PubMed
  2. Arch Neurol. 1991 Jan;48(1):26-30 - PubMed
  3. N Engl J Med. 1975 Feb 13;292(7):344-7 - PubMed
  4. Skelet Muscle. 2013 Jun 07;3(1):13 - PubMed
  5. N Engl J Med. 1991 Nov 21;325(21):1487-98 - PubMed
  6. Chest. 2010 Dec;138(6):1464-74 - PubMed
  7. Lancet. 2003 Sep 20;362(9388):971-82 - PubMed
  8. Neuromuscul Disord. 2004 May;14(5):337-45 - PubMed
  9. Curr Opin Rheumatol. 2011 Nov;23(6):595-604 - PubMed
  10. Neurol India. 2013 Mar-Apr;61(2):152-5 - PubMed
  11. Neuromuscul Disord. 2013 Nov;23(11):945-51 - PubMed
  12. Curr Rheumatol Rep. 2011 Jun;13(3):208-15 - PubMed
  13. Arch Dermatol. 2010 Jan;146(1):26-30 - PubMed
  14. J Immunol. 2009 Oct 1;183(7):4792-9 - PubMed
  15. Indian J Dermatol. 2012 Sep;57(5):375-81 - PubMed
  16. Ann N Y Acad Sci. 2010 Jan;1184:134-53 - PubMed
  17. J Rheumatol. 2013 May;40(5):550-64 - PubMed
  18. Presse Med. 2011 Apr;40(4 Pt 2):e199-208 - PubMed
  19. Rheum Dis Clin North Am. 2002 Nov;28(4):779-98, vi - PubMed
  20. Ann Neurol. 1990 Apr;27(4):343-56 - PubMed
  21. Neth J Med. 2011 Oct;69(10):410-21 - PubMed
  22. Arthritis Rheum. 2005 Jun;52(6):1824-35 - PubMed
  23. J Neuroimmunol. 2003 Sep;142(1-2):130-6 - PubMed
  24. Presse Med. 2011 Apr;40(4 Pt 2):e209-18 - PubMed

Publication Types