Myositis is a rarely-encountered
medical condition characterized by
inflammation
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...
affecting the
muscles.
The manifestations of this condition may include
skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation.
Other animal coverings, such as the arthropod exoskeleton, have different ...
issues,
muscle weakness, and the potential involvement of other organs.
Additionally,
systemic symptoms like weight loss,
fatigue
Fatigue is a state of tiredness (which is not sleepiness), exhaustion or loss of energy. It is a signs and symptoms, symptom of any of various diseases; it is not a disease in itself.
Fatigue (in the medical sense) is sometimes associated wit ...
, and
low-grade fever can manifest in individuals with myositis.
Causes
Myositis can arise from various causes, including
injury
Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants.
Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...
, certain
medication
Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...
s,
infection
An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
s, inherited muscle disorders, or
autoimmune conditions. In some instances, the origins of myositis remain
idiopathic, without a discernible cause.
* Injury: A mild form of myositis can occur with hard exercise.
A more severe form of muscle injury, called
rhabdomyolysis, is also associated with myositis.
This is a condition where an injury to the patient's muscles causes them to quickly break down.
* Medicines: A variety of different medicines can cause myositis. One of the most common types of drugs that can cause myositis are
statins, which are used to lower cholesterol levels. One of the most common side effects of statin therapy is muscle pain
which, more rarely, can lead to myositis.
* Infection: The most common infectious cause of myositis is
viral infections, such as the common cold.
Other viruses, such as
COVID-19
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic.
The symptoms of COVID‑19 can vary but often include fever ...
, are also shown to be a rare cause of myositis.
Benign acute childhood myositis has been described in children after prodromal viral infections with different viral agents.
Bacterial,
parasitic, and
fungal infections are other infectious causes of myositis.
* Inherited muscle disease: Many inherited myopathies may have secondary myositis, including
calpainopathy,
dysferlinopathy,
facioscapulohumeral muscular dystrophy,
dystrophinopathy, and ''
LMNA''-associated myopathy.
* Autoimmune:
Autoimmune disease is an abnormal immune response to specific body protein or other biomolecular target, such as one of the muscles. The three main types of idiopathic myositis (known as
inflammatory myopathies) that typically test positive for
autoantibodies are
dermatomyositis,
polymyositis, and
inclusion body myositis.
Other autoimmune diseases, such as
systemic lupus erythematosus, can also cause myositis-like symptoms.
Diagnosis
There are various tools that can be used to help diagnose myositis. The most common methods are physical examination,
electromyography (EMG),
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI),
muscle biopsy, and
blood tests. The first course of action a doctor will likely take is perform a physical exam.
The doctor assesses for muscle weakness or rashes.
Another possible test is electromyography. This test involves the insertion of small needles into the patient's muscles.
This allows a physician to look at the muscles' responses to various electrical
nerve stimuli and evaluate which muscles potentially have myositis.
Magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
can be useful in diagnosis, allowing painless,
non-invasive visualisation of any
muscle wastage.
Muscle biopsies, however, are the most reliable tests for diagnosing myositis.
There are also a variety of blood tests available that help in the diagnosis of myositis. The doctor may look for an elevation of
creatine kinase in the blood, which is indicative of muscle inflammation.
Certain
autoantibodies (antibodies that target muscle cells) can also be found in the blood, which can indicate that myositis is caused by an autoimmune disease.
Some specific examples of autoantibodies are
Anti-Jo-1, Anti-HMGCR, Anti-TIF1, etc.
Treatment
Treatment for myositis depends on the underlying cause.
For myositis, which is caused by a viral infection, no treatment is typically needed.
For myositis caused by a bacterial infection, antibiotics can be used.
For myositis caused by a medication, it is important to stop using that medication.
There are a variety of treatment options available if myositis is caused by an autoimmune disease.
Glucocorticoid
Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebra ...
s are often the first choice for treatment.
This drug works to weaken the immune system so that it is not able to attack the muscles. It is a type of
steroid
A steroid is an organic compound with four fused compound, fused rings (designated A, B, C, and D) arranged in a specific molecular configuration.
Steroids have two principal biological functions: as important components of cell membranes t ...
and can cause a wide array of side effects, such as mood changes, increased hunger, trouble sleeping, etc. Another treatment option is a steroid-sparing
immunosuppressive agent.
This also works to weaken the immune system but does not cause the side effects that steroids do. Another treatment option is a class of drugs called
biologics.
Also, intravenous
immunoglobulins (IVIg) have been shown to be effective in the treatment of myositis caused by an
autoimmune disease.
See also
*
Benign acute childhood myositis
*
Inflammatory myopathies
*
Myopathy (muscle disease)
*
Myalgia (muscle pain)
*
Masticatory muscle myositis (a disease in dogs)
*
Perimyositis
*
Sarcoidosis § Bones, joints, and muscles
References
External links
Myositis NIH
{{Myopathy
Myositis Association https://www.myositis.org
Inflammations
Muscular disorders