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Review article: the gastrointestinal complications of myositis
Author(s) -
EBERT E. C.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.04190.x
Subject(s) - medicine , polymyositis , myositis , dermatomyositis , inclusion body myositis , dysphagia , gastroenterology , muscle weakness , inflammatory myopathy , myopathy , aspiration pneumonia , weakness , skeletal muscle , creatine kinase , tongue , pathology , surgery , pneumonia
Aliment Pharmacol Ther 31 , 359–365 Summary Background The inflammatory myopathies are a group of acquired diseases characterized by a proximal myopathy caused by an inflammatory infiltrate of the skeletal muscle. The three major diseases are dermatomyositis, polymyositis and inclusion body myositis. Aims To review the gastrointestinal manifestations of myositis. Methods Over 110 articles in the English literature were reviewed. Results Dysphagia to solids and liquids occurs in patients with myositis. The pharyngo‐oesophageal muscle tone is lost and therefore patients develop nasal speech, hoarseness, nasal regurgitation and aspiration pneumonia. There is tongue weakness, flaccid vocal cords, poor palatal motion and pooling of secretions in the distended hypopharynx. Proximal oesophageal skeletal muscle dysfunction is demonstrated by manometry with low amplitude/absent pharyngeal contractions and decreased upper oesophageal sphincter pressures. Patients exhibit markedly elevated creatine kinase and lactate dehydrogenase levels consistent with muscle injury. Myositis can be associated with inflammatory bowel disease, coeliac disease and interferon treatment of hepatitis C. Corticosteroids and other immunosuppressive drugs comprise the mainstay of treatment. Inclusion body myositis responds poorly to these agents and therefore a myotomy is usually indicated. Conclusion Myositis mainly involves the skeletal muscles in the upper oesophagus with dysphagia, along with proximal muscle weakness.