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Dermatomyositis/Polymyositis, Emergency Medicine

Sean-Xavier Neath Reviewed 06/2017
 


Basics

Description

  • Dermatomyositis (DM) and polymyositis (PM) are systemic inflammatory myopathies, which represent the largest group of acquired and potentially treatable causes of skeletal muscle wea...

Diagnosis

Signs and Symptoms

History

  • PM is distinguished from DM by the absence of rash

  • Patients with PM present with muscle pain and proximal muscle weakness

  • DM presents with skin rash, muscle pain, and ...

Treatment

Pre-Hospital

  • Assess ABCs

  • Transport with elevation of head of bed

Initial Stabilization/Therapy

  • Intubation and mechanical ventilation as required

  • Nasogastric (NG) suction to prevent aspiration

  • Pneu...

Follow-Up

Disposition

Admission Criteria

  • Respiratory insufficiency

  • Aspiration pneumonia

  • Profound muscle weakness

  • Weakened cough mechanisms

  • Pharyngeal dysfunction

  • CHF

Discharge Criteria

  • Well-appearing patients ...

Pearls and Pitfalls

  • The diagnosis of an inflammatory myopathy is largely clinical supported by selected lab testing and muscle biopsy

  • Most patients improve with therapy, and many make a full functional...

Additional Reading

  • Amato  AA, Barohn  RJ. Evaluation and treatment of inflammatory myopathies. J Neurol Neurosurg Psychiatry.  2009;80:1060–1068.

  • Casciola-Rosen  L, Mammen  AL. Myositis autoantibo...

Codes

ICD9

  • 710.3 Dermatomyositis

  • 710.4 Polymyositis

ICD10

  • M33.20 Polymyositis, organ involvement unspecified

  • M33.90 Dermatopolymyositis, unspecified, organ involvement unspecified

  • M33.92 Dermatopolymyositis...

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