TY  - CHAP
M1  - Book, Section
TI  - Chapter 27. Dermatomyositis, Polymyositis, & Immune-Mediated Necrotizing Myopathy
A1  - Mammen, Andrew L.
A1  - Truong, Alex
A1  - Christopher-Stine, Lisa
A2  - Imboden, John B.
A2  - Hellmann, David B.
A2  - Stone, John H.
Y1  - 2013
N1  - 
T2  - CURRENT Diagnosis & Treatment: Rheumatology, 3e
AB  - Symmetric  proximal  muscle  weakness  progressing  over  weeks  to  months.Elevated  muscle  enzymes,  including  creatine  kinase  (CK),  aldolase,  aspartate  aminotransferase  (AST),  and  alanine  aminotransferase  (ALT).An  “irritable  myopathy”  shown  by  electromyography  (EMG).MRI  of  affected  muscles  reveals  evidence  of  edema  or  fasciitis  or  both.A  heliotrope  rash,  Gottron  sign/papules  are  pathognomonic  for  dermatomyositis.Muscle  biopsy  findings  frequently  reveal  endomysial,  perimysial,  and  perivascular  lymphocytic  infiltrates.  Except  for  perifascicular  atrophy,  which  is  pathognomonic  for  dermatomyositis,  muscle  biopsy  findings  are  variable  and  nonspecific.A  careful  family  history,  medication  list  review,  physical  examination,  laboratory  evaluation,  and  muscle  biopsy  are  critical  and  help  exclude  an  alternative  diagnosis,  such  as  an  inherited  muscle  disease  or  toxic  myopathy.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/25
UR  - accessmedicine.mhmedical.com/content.aspx?aid=57272818
ER  -