Idiopathic Orbital Myositis

Yan, Jianhua; Wu, Paul W.

doi:10.1097/scs.0000000000000510

Cited by 46 publications

(46 citation statements)

References 19 publications

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“…The most commonly used criteria for the classification of IIMs are those that were proposed by Bohan and Peter in 1975 [1]. From a clinico-pathological perspective, the IIMs fall into six categories: (1) dermatomyositis (DM; juvenile, adult), (2) polymyositis (PM; T-cell mediated, eosinophilic, granulomatous), (3) overlap syndromes (with DM, with PM, with sIBM/hIBM), (4) cancer-associated myositis, (5) inclusion body myositis (IBM), and (6) other forms (focal: orbital myositis, localised nodular myositis, inflammatory pseudotumor; diffuse: macrophagic myofasciitis, necrotizing autoimmune myopathy (NAM), infantile myositis) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Although this clinico-pathological subdivision has a predictive value in prognosis and in therapy, according to our rising knowledge of the autoantibodies, this system seems to be worn out.…”

Section: Introductionmentioning

confidence: 99%

Four dermatomyositis-specific autoantibodies—anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5—in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort

Bodoki

Nagy‐Vincze

Griger

et al. 2014

Autoimmunity Reviews

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Section: Introductionmentioning

confidence: 99%

Four dermatomyositis-specific autoantibodies—anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5—in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort

Bodoki

Nagy‐Vincze

Griger

et al. 2014

Autoimmunity Reviews

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“…Idiopathic orbital myositis is usually diagnosed clinically based on the exclusion of other inflammatory or neoplastic diseases involving extraocular muscles. [1][2][3][4][5][6][7][8][9][10][11] Excisional or needle biopsy of the extraocular muscle is usually not performed because of the difficulty in approaching thin extraocular muscles which pass in close contact with the eye globe along the anteroposterior curvature. Thus, therapeutic diagnosis with oral corticosteroids still remains to be the standard at the setting of clinical ophthalmology.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcome in 7 Patients With Idiopathic Orbital Myositis

Matsuo

2019

Jpn Clin Med

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Purpose: Idiopathic orbital myositis, a rare disease of unknown cause, presents a diagnostic puzzle because the diagnosis is based on the exclusion of other diseases. This study aims at elucidating its long-term outcome to answer a clinical question whether idiopathic orbital myositis would be a distinct clinical entity. Methods: Retrospective review was made on 7 consecutive patients (6 men and 1 woman) with the age at the initial visit ranging from 33 to 69 years (mean, 45.8 years) who were diagnosed with idiopathic orbital myositis and followed for 5 years or more (mean, 9.2 years) at a referral-based hospital. Results: Chief complaint at the initial visit was diplopia in 4 patients, blurred vision in 2 patients, and proptosis in 1 patient. On magnetic resonance imaging, 4 patients showed enlargement of a single extraocular muscle on unilateral side while 3 patients showed enlargement of multiple extraocular muscles on unilateral side or bilateral sides. No patient developed systemic diseases or other orbital lesions in the long-term follow-up. All patients at the last visit were free from symptoms, including diplopia, after tapering of prednisolone at the initial dose of 20 to 60 mg daily. Conclusion: Idiopathic orbital myositis had a favorable long-term outcome with corticosteroid administration and appears to be a distinct clinical entity without systemic involvement.

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“…NSOİ'nin tedavisinde sistemik steroidler (oral prednizolon) 1 mg/kg /gün tedavide ilk basamak olarak kullanılmaktadır (2). Fakat bazı yazarlara göre tek bir ekstraoküler kas tutulumu gözlem-lendiğinde ilk olarak düşük doz oral steroidleri (20 mg/ gün prednizolon) ya da nonsteroid antiinflamatuvar ilaç-ları önermektedir (12). Eğer birden çok ekstraoküler kas tutulumu görüldüğünde yüksek doz steroid (40-60 mg/ gün prednizolon) tedavisi önermektedir (12).…”

Section: Discussionunclassified

“…Fakat bazı yazarlara göre tek bir ekstraoküler kas tutulumu gözlem-lendiğinde ilk olarak düşük doz oral steroidleri (20 mg/ gün prednizolon) ya da nonsteroid antiinflamatuvar ilaç-ları önermektedir (12). Eğer birden çok ekstraoküler kas tutulumu görüldüğünde yüksek doz steroid (40-60 mg/ gün prednizolon) tedavisi önermektedir (12). İdiyopatik orbital miyozitte kortikosteroidlere hızlı ve oldukça iyi yanıt olmasına rağmen, rekürrens olasılığı nedeniyle steroid tedavisinin 4-6 hafta devam edilmesi ve yavaş yavaş azaltılarak kesilmesi önerilmektedir.…”

Section: Discussionunclassified

Idiopathic orbital myositis in a pediatric patient and treatment

Capkin¹,

Bilak²,

Bi̇lgi̇n³

et al. 2017

Eur J Ther

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hastalıktır. Dokuz yaşında erkek hasta, 3 gün önce başlayan sola bakışta ağrı ve çift görme şikayeti ile kliniğimize başvurdu. Göz hareketleri muayenesinde sol gözde sola bakış kısıtlılığı ve diplopi mevcuttu. Her iki gözde göz hareketleri diğer bakış yönlerine normaldi. Sol göz kapağında minimal ödem tespit edildi. İdiyopatik orbital miyozit, tiroid oftalmopati, orbital sellülit ön tanısı ile orbital manyetik rezonans görüntüleme (MRG) istendi. Orbital MRG sol medial rektus kasında belirgin kalınlaşma tespit edildi. Tiroide fonksiyon testlerinin normal sınırda olması ile tiroid oftalmopatisi dışlandı ve orbital MRG'de; orbital apse ve sinüzit bulgusuna ve sol medial rektus kası dışında ekstraoküler infiltrasyona rastlanmaması nedeniyle de orbital sellülit dışlandı. İdiyopatik orbital miyozit tanısı konularak 30 mg/gün oral prednizolon tedavisi başlandı. Birinci haftanın sonunda diplopi ve sola hareket bakış kısıtlılığı tamamen düzelmişti. Akut ağrı ile başlayan oküler hareket kısıtlılığı ve diplopi gözlenen idiyopatik orbital miyozit, nonspesifik orbital inflamasyon (NSOİ)'nun bir alt grubu olarak çocuk hastalarda nadiren görülmekte ve kolaylıkla atlanabilmektedir. Dikkatli bir muayene ve MRG görüntüleme sisteminin sayesinde orbital miyozit düşü-nülmesi gereken tanılardan biri olmalıdır. Böylelikle gecikmiş tanı ve ihtiyaç olmayan antibiyotik kullanımı ve gereksiz biyopsi önle-nebilir. Anahtar Kelimeler: Orbital miyozit, MR görüntüleme, prednizolon ABSTRACTIdiopathic orbital myositis is an autoimmune orbital disease characterized by one or more non-granulomatous, non-infectious, non-neoplastic extraocular muscle inflammation whose etiology was unknown. A 9-year-old male patient was admitted to our clinic with diplopia and a pain in left-gaze starting 3 days ago. There was a restriction in left-gaze in the left eye and diplopia in the examination of eye movements. The other gaze direction were normal in both eyes movements. Minimal edema was also detected in the left eyelid. Orbital MRI was asked for the preliminary diagnosis of idiopathic orbital myositis, thyroid eye disease, and orbital cellulitis. It was a marked thickening detected in the orbital MRI left medial rectus muscle. Owing to thyroid function tests are in the normal range thyroid ophthalmopathy were excluded and in orbital MRI; Orbital cellulitis were excluded because of the fact that there were no orbital abscess and sinusitis findings and also no extra-ocular infiltration outside the left medial rectus muscle. 30 mg/day of oral prednisolone therapy was started after diagnosing with idiopathic orbital myositis. At the end of the first week, the restriction in left-gaze and the diplopia was completely improved. Ocular movement limitation starting with acute pain and diplopia are rarely seen in pediatric patients and can easily be overcome as a subgroup of the observed idiopathic orbital myositis and the non-specific orbital inflammation (NSOI). Thanks to a careful examination and MRI imaging system, orbital myositis should be one of the diagnoses ...

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Idiopathic Orbital Myositis

Abstract: Orbital myositis occurs in multiple clinical manifestations and may be recurrent. Imaging is an important technique for use in diagnosis. Systemic corticosteroid represents an effective approach for treatment.

Cited by 46 publications

References 19 publications

Four dermatomyositis-specific autoantibodies—anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5—in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort

Four dermatomyositis-specific autoantibodies—anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5—in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort

Long-term Outcome in 7 Patients With Idiopathic Orbital Myositis

Idiopathic orbital myositis in a pediatric patient and treatment

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