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M33.20
Polymyositis, organ involvement unspecified
Polymyositis (pol-e-my-o-SY-tis) is an uncommon inflammatory disease that causes muscle weakness affecting both sides of your body. Having this condition can make it difficult to climb stairs, rise from a seated position, lift objects or reach overhead.Polymyositis most commonly affects adults in their 30s, 40s or 50s. It's more common in blacks than in whites, and women are affected more often than men. Signs and symptoms usually develop gradually, over weeks or months.While there is no cure for polymyositis, treatment — ranging from medications to physical therapy — can improve your muscle strength and function.
Symptoms
The muscle weakness associated with polymyositis involves the muscles closest to the trunk, such as those in your hips, thighs, shoulders, upper arms and neck. The weakness affects both the left and right sides of your body, and tends to gradually worsen
Causes
The exact cause of polymyositis is unknown, but the disease shares many characteristics with autoimmune disorders, in which your immune system mistakenly attacks your own body tissues.
Risk factors
Your risk of polymyositis is higher if you have lupus, rheumatoid arthritis, scleroderma, or Sjogren's syndrome.
Complications
Possible complications of polymyositis include:
- Difficulty swallowing. If the muscles in your esophagus are affected, you may have problems swallowing (dysphagia), which in turn may cause weight loss and malnutrition.
- Aspiration pneumonia. Difficulty swallowing may also cause you to breathe food or liquids, including saliva, into your lungs (aspiration), which can lead to pneumonia.
- Breathing problems. If your chest muscles are affected by the disease, you may experience breathing problems, such as shortness of breath or, in severe cases, respiratory failure.
- An idiopathic inflammatory disorder affecting the muscles. It presents with symmetrical proximal muscle weakness and elevated skeletal muscle enzymes.
- An inflammatory disease of the muscles closest to the center of the body. It causes weakness, inability to stand, climb stairs, lift, or reach. It may also cause muscle pain and difficulty swallowing, and may affect the lungs and heart. Having polymyositis increases the risk of certain types of cancer.
- Diseases characterized by inflammation involving multiple muscles. This may occur as an acute or chronic condition associated with medication toxicity (drug toxicity); connective tissue diseases; infections; malignant neoplasms; and other disorders. The term polymyositis is frequently used to refer to a specific clinical entity characterized by subacute or slowly progressing symmetrical weakness primarily affecting the proximal limb and trunk muscles. The illness may occur at any age, but is most frequent in the fourth to sixth decade of life. Weakness of pharyngeal and laryngeal muscles, interstitial lung disease, and inflammation of the myocardium may also occur. Muscle biopsy reveals widespread destruction of segments of muscle fibers and an inflammatory cellular response. (Adams et al., Principles of Neurology, 6th ed, pp1404-9)
- Inflammation of a number of voluntary muscles simultaneously.
Associated conditions
Although these are not complications, polymyositis is often associated with other conditions that may cause further complications of their own, or in combination with polymyositis symptoms. Associated conditions include:
- Raynaud's phenomenon. This is a condition in which your fingers, toes, cheeks, nose and ears initially turn pale when exposed to cold temperatures.
- Other connective tissue diseases. Other conditions, such as lupus, rheumatoid arthritis, scleroderma and Sjogren's syndrome, can occur in combination with polymyositis.
- Cardiovascular disease. Polymyositis may cause the muscular walls of your heart to become inflamed (myocarditis). In a small number of people who have polymyositis, congestive heart failure and heart arrhythmias may develop.
- Lung disease. A condition called interstitial lung disease may occur with polymyositis. Interstitial lung disease refers to a group of disorders that cause scarring (fibrosis) of lung tissue, making lungs stiff and inelastic. Signs and symptoms include a dry cough and shortness of breath.
- Cancer. People who have polymyositis have an elevated risk of cancer.
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