2015 Persian Gulf Criteria for Early Diagnosis of Polymyositis/Dermatomyositis
The idiopathic inflammatory myopathies are a group of chronic inflammatory diseases with unknown etiology involving muscle resulting myositis. It may be an autoimmune process and multiple autoantibodies have been detected in this group of disorders. Polymyositis (PM) is a member of this group in which Myositis is the predominant feature of a systemic disease involving muscle (Myositis), heart (Myocarditis, conduction abnormalities, arrhythmia and coronary heart disease), lung (Interstitial lung disease), Gastrointestinal (dysphagia, nasal regurgitation and/or aspiration), joints (arthralgia/arthritis) and so on. Myositis as the cardinal involvement in PM is presented as symmetric proximal muscle weakness. climbing stairs and getting up with difficulty are the history of these patients. Muscle enzymes including Creatine Kinase (CK), Lactate Dehydrogenase (LDH), aldolase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) can be increased in patients with myositis. In Dermatomyositis, skin involvement is a major finding along with other manifestations as same as all the features can be seen in PM. As same as other systemic inflammatory Rheumatic diseases the diagnosis of PM/DM can be established by clinical/laboratory judgment of an expert rheumatologist. Bohan and Peter classification criteria for PM/DM has been used since 1975. We know that, Bohan and Peter criteria cannot exactly differentiate the polymyositis from muscular dystrophies and many other myopathies and after that, the discovery of MSA and detection of the role of MRI in diagnosis of muscle inflammation have been introduced. In this letter, the corresponding author wants to deliver a new diagnostic criteria for early detection of PM/DM along with a guideline for approaching to diagnosis of PM/DM.
Polymyositis, Dermatomyositis, Bohan and Peter Criteria, Persian Gulf Criteria
Hoogendijk JE, Amato AA, Lecky BR, et al. 119th ENMC international workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Netherlands. NeuromusculDisord 2004; 14:337.
Denbow CE, Lie JT, Tancredi RG, Bunch TW. Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum 1979; 22:1088.
Lundberg IE. The heart in dermatomyositis and polymyositis. Rheumatology (Oxford) 2006; 45 Suppl 4: iv18.
deMerieux P, Verity MA, Clements PJ, Paulus HE. Esophageal abnormalities and dysphagia in polymyositis and dermatomyositis. Arthritis Rheum 1983; 26:961.
Katzap E, Barilla-LaBarca ML, Marder G. Antisynthetase syndrome. Curr Rheumatol Rep 2011; 13:175.
Hochberg MC, Feldman D, Stevens MB. Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. Semin Arthritis Rheum 1986; 15: 168.
Targoff IN. Myositis specific autoantibodies. Curr Rheumatol Rep 2006; 8:196.
Gunawardena H, Betteridge ZE, McHugh NJ. Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression. Rheumatology (Oxford) 2009; 48:607.
Love LA, Leff RL, Fraser DD, et al. A new approach to the classification of idiopathic inflammatory myopathy: myositis-specific autoantibodies define useful homogeneous patient groups. Medicine (Baltimore) 1991; 70:360.
Reichlin M, Arnett FC Jr. Multiplicity of antibodies in myositis sera. Arthritis Rheum 1984; 27:1150.
May DA, Disler DG, Jones EA, et al. Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics 2000; 20 Spec No:S295.
Callen JP. Cutaneous manifestations of dermatomyositis and their management. Curr Rheumatol Rep 2010; 12:192.
Marvi U, Chung L, Fiorentino DF. Clinical presentation and evaluation of dermatomyositis. Indian J Dermatol. 2012; 57(5): 375-81.
Gunawardena H, Wedderburn LR, Chinoy H, et al. Autoantibodies to a 140-kd protein in juvenile dermatomyositisare associated with calcinosis. Arthritis Rheum 2009; 60:1807.
Drake LA, Dinehart SM, Farmer ER, et al. Guidelines of care for dermatomyositis. American Academy of Dermatology. J Am Acad Dermatol 1996; 34:824.
Krathen MS, Fiorentino D, Werth VP. Dermatomyositis. Curr Dir Autoimmun. 2008; 10: 313-32.
Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975; 292:403.
Salehi I, Khazaeli S, Khak M. Early diagnosis of rheumatoid arthritis: an introduction to the newly designed Iran Criteria for Rheumatoid Arthritis. Rheumatol Int. 2013; 33(1): 45-50
Salehi-Abari I, Khazaeli S, Khak M. Early diagnosis of ankylosing spondylitis: an introduction to the newly designed Iran criteria for ankylosing spondylitis. Rheumatol Int. 2013; 33(5): 1303-8
Salehi-Abari I, Khazaeli S, Khak M, Motesaddi M, Hasibi M. Early diagnosis of granulomatosiswith polyangiitis: an introduction to the newly designed Iran criteria for early diagnosis of granulomatosiswith polyangiitis. Indian Journal of Rheumatology. 2013
Salehi-Abari I. 2015 ACR/SLICC Revised Criteria for Diagnosis of Systemic Lupus Erythematosus. Autoimmune Dis Ther Approaches Open Access. 2015; 2:114
Salehi-Abari I, Khazaeli S, Niksirat A. Chondromalacia Patella and New Diagnostic Criteria. Open Science Journal of Clinical Medicine. 2015; 3(4):126-8.