Dysphagia in Inflammatory Myopathy: Self-report, Incidence, and Prevalence

Abstract

This study compared self-reported incidence and prevalence of dysphagia in inflammatory myopathy diseases with instrumental data from videofluoroscopy in a cohort of 18 patients with inflammatory myopathies (inclusion body myositis, polymyositis, and dermatomyositis). We found a high self-report of incidence of dysphagia and demonstrated that symptoms described by the patients follow a characteristic pattern. We conclude that there is a high incidence of dysphagia in all three of the inflammatory myopathies. Questions about swallowing should routinely be included in inflammatory myopathy patient examinations in order to appropriately refer patients for further investigation of their swallowing function and avoid the complications associated with dysphagia.

A Case of Refractory Dysphagia in the Context of Polymyositis Treated with Subcutaneous Immunoglobulin and Review of the Literature

“…Dysphagia in the context of inflammatory muscle diseases, such as polymyositis or dermatomyositis and cancer associated myositis [4], is frequently described, with a highly variable prevalence of 30-60% [5,6].…”

“…Dysphagia can sometimes be associated to several morbidities, including malnourishment, dehydration, social isolation, respiratory infections due to aspiration, and mortality [6].…”

Immune and myodegenerative pathomechanisms in inclusion body myositis

“…Paraspinal and axial muscles may be affected, resulting in head drop and camptocormia 12. Depending on the study, oropharyngeal dysphagia is reported in up to 40–86% of IBM cases, mostly due to upper esophageal sphincter dysfunction 13, 14, 15, 16. It develops insidiously, leading to frequent choking episodes and is, alongside pneumonia as a result of immobility, considered to be a potentially fatal complication of IBM.…”

“…It develops insidiously, leading to frequent choking episodes and is, alongside pneumonia as a result of immobility, considered to be a potentially fatal complication of IBM. Importantly, dysphagia may be an isolated, initial manifestation and IBM should be considered by the examining physician as differential diagnosis for new onset of dysphagia in the elderly 13, 14, 17, 18, 19, 20, 21. Early in the disease course, tendon reflexes remain unaffected, however, hyporeflexia may occur at later stages of the disease due to significant muscle atrophy 19.…”

Schluckstörungen im Alter

“…Für die Dermatomyositis liegen die Häufigkeitsanga-ben bei ca. 20%, für die Polymyositis bei 30-60% und für die Einschlusskörper-chenmyositis zwischen 65 und 86% [16]. Neben neurologischen Erkrankungen spielen in diesem Kontext insbesondere auch Erkrankungen aus den Fachgebieten der Hals-Nasen-Ohren-Heilkunde, der Gastroenterologie und der Zahnheilkunde eine große Rolle.…”