Polymyositis: A Survey of 89 Cases With Particular Reference to Treatment and Prognosis

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

“…In four, weakness was expressed as a summation of scores according to modifications of the Medical Research Council (MRC) grading system [31], but the selection and number of muscles tested was comparable in only two investigations [28,29]. Outcome measures to assess disability or handicap were even more diverse and included a disability grading system designed by Rose and Walton [32], a modified Convery assessment scale [28,33], the neuromuscular symptom scale [27], the Barthel index [34], a 0 -10 rating scale for the global assessment by the patient, and timed walking tests. Their validity, sensitivity, and reliability for myositis have not been established, which hampers the interpretation of results.…”

Lymphotoxin formation by lymphocytes and muscle in polymyositis

“…Fig. 3 compares the elution characteristics of purified lymphotoxin, prepared as described above, and the (4)(5)(6), the presence of autoantibodies (1,2,4,(6)(7)(8), and the recent report of fluorescent antibody staining of immunoglobulin and C3 or in the vessels in some polymyositis patients (9), have suggested a humoral immune mechanism in this disease. In the few reported cases associated with carcinomas (22)(23)(24), anti-tissue antibodies have also been identified.…”

“…Positive tests for rheumatoid factor (1-3) and antinuclear antibody (4) have been reported. In some patients, characteristic findings of systemic lupus erythematosus (5)(6)(7)(8) or rheumatoid arthritis (2) have accompanied those of polymyositis. Recently focal deposits of C'3, IgG, and IgM have been identified in the vessels of some patients with active polymyositis (9) and in association with degenerating muscle fibers.…”

The Inflammatory Myopathies

“…late adult life but are particularly common during the fifth and sixth decades. Women are more often affected than men (DeVere & Bradley 1975) and approximately 4-5 cases occur per million population each year (Rose & Walton 1966). In acute cases, profound generalized muscular weakness, pain and tenderness may develop over a period of a few days with a striking increase in serum CK activity and sometimes with myoglobinuria which may occasionally be sufficiently acute to cause fatal renal failure.-These patients are acutely ill with high fever, malaise, dysphagia and sometimes with associated oedema of the limbs and face, particularly in the periorbital regions, upper arms and thighs.…”