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MUSCULOSKELETAL AND CONNECTIVE TISSUE DISEASES
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Systemic Lupus Erythematosus Juvenile Arthritis Scleroderma Ankylosing Spondylitis
Sjogren's Syndrome Polymyalgia Rheumatica Polymyositis Osteomyelitis
Mixed Connective Tissue Disease Paget's Disease Infectious Arthritis Osteogenic Sarcoma
Reiter's Syndrome Metastatic Carcinoma of Bone Rheumatoid Arthritis .
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POLYMYOSITIS

Skeletal Muscle: In polymyositis an apparently normal/non-necrotic muscle fiber is surrounded and infiltrated by lymphocytes. This is a reflection of immune mediated reaction towards skeletal muscle fibers.
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LABORATORY FINDINGS
  • Slightly to moderately increased sedimentation rate - correlates with disease activity;  may be normal in the chronic form of disease
  • *Increased creatinine phosphokinase (CPK) (MM and MB isoenzymes**) and aldolase reflect muscle injury;  enzyme release, and disease activity.
  • Increased lactate dehydrogenase (LDH), serum glutamic-oxaloacetic transminase (SGOT) (AST {aspartate aminotransferase}) - usually elevated
  • *Increased LDH isoenzymes LDH2-LDH5, especially LDH5 - indicates active skeletal-muscle necrosis in acute polymyositis
  • Slightly increased serum y-globulin, polyclonal pattern
  • Occasionally, positive rheumatoid factor
  • Presence of antibody against PM-1 antigen - this is a nonhistone acid nuclear antigen often associated with polymyositis
  • Occasionally, presence of antinuclear antibody
  • Mild normocytic anaemia
  • *Muscle biopsy shows characteristic inflammation and muscle degeneration and regeneration.
  • Increased urinary creatine-creatinine ratio reflects increased release and excretion of creatinine from necrotic muscle.
*This finding is of diagnostic significance.


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