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Polymyositis and dermatomyositis treatment

Polymyositis and dermatomyositis - Natural treatment

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  • On 15/10/2020 at 12:02
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Polymyositis and dermatomyositis - diagnosis

In the event of severe general symptoms, such as fever, fatigue and weakness, the patient should consult their general practitioner.

When visiting, please describe in detail:

  • symptoms
  • their duration,
  • the circumstances in which they arose.

These are non-specific symptoms, but will alert the doctor that something is wrong with the body. If you develop symptoms related to muscle weakness, see your doctor immediately.

Once the diagnosis is made, it is time for the patient to learn more about the disease he or she is struggling with. At this point, it's worth asking your doctor a few questions:

  • How often do I have to come for the inspection?
  • What tests will be performed during the inspection and how to prepare for these tests?
  • How to proceed in the event of complications of the disease?
  • How can you cure / fight the disease?
  • Are there any activities that should be limited?
  • Who should participate in the therapeutic process besides the doctor?
  • What is the prognosis of the disease?

There will probably be many more questions to ask. The key is not to be afraid to ask them. The doctor is there for the patient and at this moment puts him at the service of his knowledge as best he can.

Natural herbal remedy to treat polymiosyte

Here is a very effective natural remedy to permanently cure polypyositis and improve muscle capacity. This natural treatment reduces inflammation and pain in bone and joint disorders (rheumatoid arthritis, polymyositis, osteoarthritis, cervical spondylosis, gout, myositis, fibromyalgia, carpal tunnel, tendonitis, bursitis, torticollis - contracture of the muscles of the neck) by reducing the action of the 5-LOX enzyme of leukotrienes involved in inflammation, autoimmune reactions, cancer, scaling. It increases joint mobility and participates in the synthesis of glucosamine sulfate and hyaluronic acid. More treatmentstarted earlier, the more effective it is, resulting in fewer complications. However, as in many conditions, no single approach is the best. Our doctor will tailor the treatment strategy based on your symptoms and their response to treatment.

Click on the following image to see the treatment .

Testicular atrophy

For more information, our Experts are at your service: Tel / whatsapp: +33644661758 +22990312738 

 

Polymyositis and dermatomyositis - which doctor?

After an initial assessment of the state of health and a rough diagnosis (if inflammatory muscular disease of unknown cause is suspected), the general practitioner should refer the patient to a   specialist  rheumatologist . The latter, as a specialist in musculoskeletal disorders, will be able to make a more precise diagnosis. He will also be able to suggest the most suitable treatment and closely monitor the patient during the illness.

The earlier a diagnosis of dermatomyositis, polymyositis, or other unknown inflammatory muscle disease is diagnosed, the sooner treatment can be started and possible serious complications can be avoided.

Other doctors you may want to see because of your problems include:

  • ophthalmologist,
  • internist,
  • dermatologist,
  • gastrologist,
  • cardiologist,
  • pulmonologist.
 

Polymyositis and dermatomyositis - an autoimmune disease

The described disease is included in the autoimmune circle. This means that the immune system, as a result of a defect unknown to us, attacks the cells in our body and damages them. In the case of polymyositis, cellular immunity is activated and in the case of dermatomyositis, the humoral immune system is activated. Cellular immunity is a type of immunity in which certain types of white blood cells are involved. Antibodies produced by B lymphocytes are responsible for humoral immunity.

When the immune system is not activated properly, white blood cells travel to the muscles where they release a whole range of substances that promote inflammation (pro-inflammatory substances). In muscles, the inflammatory process damages all muscle fibers or their parts. The body tries to regenerate (restore) muscles at the same time, but without treatment, destructive processes are stronger than repair processes.

Thus, autoimmune mechanisms play a major role in the formation of polymyositis and dermatomyositis, which are initiated in genetically sensitive individuals by an environmental factor, for example infection.

 

Polymyositis and dermatomyositis - research

As with any illness, the doctor will begin the interview with the patient by taking a  medical history and performing a physical exam  . In the conversation, the doctor will largely focus on the weakening of muscle strength (how long ago it appeared, what parts of the muscles it concerns), and the physical examination will extend to various types of strength measurements muscle (to objectively assess whether the weakening is actually occurring).

The diagnosis of polymyositis or dermatomyositis, in addition to the history and physical examination, is based on the results of the following auxiliary tests:

  • blood test (level of markers of muscle damage, level of inflammatory markers, presence of characteristic antibodies),
  • electromyography,
  • muscle biopsy,
  • imaging tests (x-rays of the bones and joints, computed tomography of the chest, magnetic resonance imaging of the muscles),
  • ECG

Of course, a doctor does not need to perform all of the above tests to determine PM / MD. The research panel is selected individually for each patient, although it almost always includes blood tests and one of the imaging tests. If PM / DM is clearly suspected, an electromyography and muscle biopsy will be performed.

 

Polymyositis and dermatomyositis - blood test

The blood test checks the level of muscle enzymes  - especially creatine kinase (CK), aldolase, lactate dehydrogenase (LDH). Their high blood levels indicate that the muscle has been damaged by inflammation and that the damaged cells have released enzymes from inside. CRP and ESR are also measured in the blood. These are inflammatory markers that tell us if and to what extent inflammation is occurring in the body.

Finally, it is possible to examine whether the blood contains antibodies characteristic of PM / DM, ie  MSA (antibodies specific for myositis), including anti-Jo-1, anti-SRP and anti-Mi-2. The course of the disease is strongly associated with the presence of antibodies, for example in people with anti-Mi-2 antibodies, dermatomyositis responds well to treatment, and in people with anti-PRS polymyositis is usually acute and severe.

 

Polymyositis and dermatomyositis - electromyographic examination

It allows you to determine the location and nature of changes in the muscles and to assess the progression of the disease by measuring the conduction of electrical impulses in the muscle. The test is done in two ways  , depending on what part of the body area we want to include in the assessment.

  1. The first method is to insert a special needle into the muscle (needle electromyography) to examine it.
  2. The second method (global electromyography) involves attaching electrodes to the skin in several places and allows to examine the extent of the disease process.

The patient does not have to prepare for the examination in any particular way, but remember  not to lubricate the skin with creams on the day of the examination and to wash the area well before the examination  . The exam lasts approximately 45 minutes and is not complicated. Before the procedure, you should tell the doctor about any medications you are taking all the time (especially if you are taking anticoagulants) and any chronic illnesses you have. During the examination, you must report to the attending physician if the injection site becomes painful.

 

Polymyositis and dermatomyositis - biopsy

A  100% biopsy is done to confirm the presence of inflammation and consequent damage to the muscles. This is a surgical procedure  in which a piece of muscle is cut. Then it is specially prepared and evaluated under a microscope by a specialized pathologist.

Common places where a biopsy is done are muscle:

  • quadriceps thighs,
  • two-headed arms (biceps),
  • shoulder.

Of course, the choice of where to take the sample depends primarily on where the symptoms of weakness are.

 

Polymyositis and dermatomyositis - imaging studies

Among  imaging tests, x-rays of the bones and joints  may show muscle calcifications and osteoporosis. A chest computed tomography is performed if lung damage is suspected. Magnetic resonance imaging (MR) is done to assess where the inflammation is in the muscles. The MRI result helps you choose the site for the biopsy.

An electrocardiogram (ECG)  tells us whether the disease has affected the heart muscle and is leading to disturbances in the conduction of electrical impulses.

Unfortunately, modern medicine does not know of a cure that can cure PM / DM. The treatment currently in use is aimed at reducing the symptoms of the disease and slowing or stopping its progression.

 

Polymyositis and dermatomyositis - drugs

Treatment for polymyositis and dermatomyositis includes pharmacotherapy (glucocorticoids (GCS), immunosuppressants) and physiotherapy.

Pharmacotherapy

Treatment begins with the use of high doses of  glucocorticosteroids  (prednisone, methylprednisolone). They are administered orally or intravenously. They are designed to prevent the inflammatory process from damaging the muscles. They usually have to be used for years, sometimes even for life. Their dose is constantly determined by the doctor, depending on the symptoms and the results of auxiliary tests. When using GCS, calcium and vitamin D3 supplementation is also done in order to prevent osteoporosis. If osteoporosis occurs during the use of glucocorticoids (a side effect of the use of glucocorticoids), bisphosphonates, that is, drugs that inhibit bone destruction, are added to the treatment. When taking GCS, the patient should remember that he should not stop the treatment suddenly, as this can lead to serious health problems. If possible, the dose of GCS is reduced slowly and only under medical supervision.

Unfortunately, glucocorticoids do not always sufficiently inhibit the progression of PM / MD. In these patients, immunosuppressants (aimed at "silencing" the immune system) - usually  methotrexate  (taken by mouth or by injection) or  azathioprine  (an oral medicine) are started. In the case of the use of methotrexate, supelmentation with folic acid is also included. Mycophenolate mofetil (CellCept) is used if patients become intolerant to methotrexate. If a patient with PM / DM develops interstitial lung disease or inflammation of the blood vessels, cyclophosphamide (Endoxan) is started. When no immunosuppressive drug shows improvement, intravenous human immunoglobulin preparations are included in the treatment.

Currently,  biological drugs  are in the research phase  ,  such as:

  • rituximab,
  • infliximab,
  • tacrolimus.

These are drugs that are used successfully, for example, in rheumatoid arthritis. It is not yet known how effective they will be in the treatment of PM / DM.

 

Polymyositis and dermatomyositis - physiotherapy

Physiotherapy plays an important role in the treatment of polymyositis and dermatomyositis. The start period and the profile of the exercises are individually chosen according to the patient's needs. It is worth talking to your doctor and physiotherapist. It should be remembered that properly selected and correctly performed exercises will allow the patient to lead a normal life despite serious illness.

Bed rest is recommended during acute episodes of illness. At the same time, such people must be rehabilitated (performing passive exercises) by a specialist in order to avoid muscle contractions and joint deformities. Moderately weak patients should exercise to improve muscle strength. As the acute episode of the disease improves, the exercise should become more intense.Patients who have experienced a slight decrease in muscle strength should try to participate in normal daily activities and perform isotonic and aerobic exercise in addition (remember that physical exertion should not exceed 60% of the maximum consumption of oxygen - ask your physiotherapist about this). Exercising in the water is very beneficial because of the relief obtained in the aquatic environment.

 

Polymyositis and dermatomyositis - prevention

Unfortunately, we do not know how to prevent the formation of PM / DM. We know that when the disease does appear, the key is:

  • see a doctor immediately,
  • rapid diagnosis,
  • beginning of treatment,

which will bring the disease into remission. On the part of the patient, the will to fight the disease, not to succumb to the situation, to follow the recommendations of the doctor and physiotherapist is important. An active lifestyle, exercise, physical therapy, and a positive outlook on life will make it easier to control the disease.

  • Positive attitude towards life,
  • not succumb to the disease,
  • cooperation with a doctor and physiotherapist is essential.

Since PM and DM are chronic diseases, it is important to stress the importance of factors such as  maintaining a healthy and "healthy" diet, weight control, and adequate control of any other chronic disease  . It should also be remembered that regular exercise is the basis for maintaining good mobility. With proper treatment, 88-93% of patients survive for five years (from diagnosis), and ten years - 83-88%.

Patients with dermatomyositis who develop a photosensitive rash  should protect their skin from overexposure to the sun  . They should avoid sunbathing and wearing clothes that expose large areas of skin. Wear long-sleeved clothing, long-legged pants, and hats (to protect your face). Sunscreen with high sunscreen should be applied to other uncovered parts of the body.

 

Polymyositis and dermatomyositis - recommendations

You should agree with your doctor (rheumatologist) on how often you should go for an examination and what to do if the disease gets worse or if there are side effects from the drugs used. Together you should try to choose drugs that the patient will be able to take at the least painful time and as much as possible independently (without the need to constantly go to the outpatient clinic). At the same time, it should be remembered that more frequent visits to the doctor allow better control and better monitoring of the disease. Regular check-ups should check for the development of cancer (the risk of malignancy is highest in the first three years after diagnosis), heart or lung disease.

It is worth monitoring your condition:

  • health,
  • Efficiency,
  • pain level

using a simple  quiz  HAQ of  2 pages  (of health assessment questionnaire). It must be completed at least once every six months. The frequency of completing the questionnaire can be agreed with the doctor.

Patients who have difficulty swallowing should be given an appropriate diet (semi-solid or liquid depending on the degree of esophageal dysfunction). Placement in bed is also important. At least two pillows should be placed under the head so that the head is higher than the rest of the body. This will reduce symptoms such as heartburn and prevent you from choking on stomach contents while you sleep.

For more information , our experts are at your service: Tel / whatsapp: +33644661758 +22990312738 

 
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