Polymyositis and Dermatomyositis

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Polymyositis vs. polymyalgia rheumatica

Polymyositis is an inflammatory, destructive, autoimmune muscle disease, usually with weakness but unusually with pain. Polymyalgia rheumatica is an inflammatory disease of muscle that always causes symmetrically painful muscles. Polymyalgia rheumatica is not destructive to muscles.

What causes polymyositis and dermatomyositis?

To date, no cause of polymyositis has been isolated by scientific researchers. There are indicators of heredity (genetic) susceptibility that can be found in some patients. There is indirect evidence of infection by a virus that has yet to be identified in a muscle disease related to polymyositis that is particularly resistant to treatment, called inclusion body myositis. The pathologist, a physician specialist who interprets the microscope findings of muscle tissue, diagnoses this muscle disease. The muscle tissue in inclusion body myositis displays clear areas within the muscle cells (called vacuoles) when viewed under the magnification of a microscope.

Researchers have found that T-cells of the immune system in some polymyositis or dermatomyositis patients reacted against cytomegalovirus (CMV) and that detectable antibodies against CMV were present. Their conclusion was that there may be subsets of patients who develop their disease, in part, because of infection with this particular virus.

Aside from diseases with which polymyositis can be associated (as mentioned above), many other diseases and conditions can mimic polymyositis. These include nerve-muscle diseases (such as muscular dystrophies), drug toxins (such as alcohol, cocaine, steroids, colchicine, hydroxychloroquine, and cholesterol-lowering drugs, called statins), metabolic disorders (where muscle cells are unable to process chemicals normally), hormone disorders (such as abnormal thyroid), inclusion body myositis, calcium and magnesium conditions, and infectious diseases (such as influenza virus, AIDS, streptococcus and Lyme bacteria, pork tapeworm, and schistosomiasis).

Medically Reviewed by a Doctor on 5/18/2016

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