Multiple Skeletal Muscle Metastases from Colon Carcinoma Preceded by Paraneoplastic Dermatomyositis

Skeletal muscle metastases are very rare events in colorectal carcinoma. By contrast, dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous manifestations and a well-recognized association with several human malignancies and, among others, colorectal cancer. Here, we report the case of a 71-year-old woman with paraneoplastic dermatomyositis followed by the development of a metastatic colon cancer. Interestingly, this patient developed multiple skeletal metastases which were preceded by the worsening of systemic symptoms of dermatomyositis. This observation suggests that, while muscle tissue is usually resistant to the development of tumor metastases, the inflammatory and immune response which characterizes and boosts paraneoplastic myopathy may represent a favorable soil for tumor cell invasion and metastasization to skeletal muscles.

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The Functional Roles of RNAs Cargoes Released by Neutrophil-Derived Exosomes in Dermatomyositis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.727901 ◽

2021 ◽

Vol 12 ◽

Author(s):

Liya Li ◽

Xiaoxia Zuo ◽

Di Liu ◽

Hui Luo ◽

Honglin Zhu

Keyword(s):

Skeletal Muscle ◽

Target Genes ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

Signalling Pathways ◽

Bioinformatics Analyses ◽

Cutaneous Manifestations ◽

Functional Roles ◽

Real Time Quantitative Pcr ◽

Development And Differentiation

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by cutaneous manifestations. We first identified the profiles of noncoding RNAs (lncRNAs and miRNAs) in peripheral neutrophil exosomes (EXOs) of DM patients and explored their potential functional roles. Bioinformatics analyses were performed with R packages. Real-time quantitative PCR was used to validate the altered RNAs in DM neutrophil EXO-stimulated human dermal microvascular endothelial cells (HDMECs) and human skeletal muscle myoblasts (HSkMCs). In DM neutrophil EXOs, 124 upregulated lncRNAs (with 1,392 target genes), 255 downregulated lncRNAs (with 1867 target genes), 17 upregulated miRNAs (with 2,908 target genes), and 15 downregulated miRNAs (with 2,176 target genes) were identified. GO analysis showed that the differentially expressed (DE) lncRNAs and DE miRNAs participated in interleukin-6 and interferon-beta production, skeletal muscle cell proliferation and development, and endothelial cell development and differentiation. KEGG analysis suggested that DE lncRNAs and DE miRNAs were enriched in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways. Many novel and valuable DE lncRNAs and DE miRNAs interacted and cotargeted in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways. Our study suggests that neutrophil EXOs participate in DM pathogenesis through lncRNAs and miRNAs in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways.

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Polymyositis and dermatomyositis

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.191107 ◽

2010 ◽

pp. 3692-3698

Author(s):

John H. Stone

Keyword(s):

Cytotoxic T Cells ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

Hla Class I ◽

Muscle Enzymes ◽

Calcinosis Cutis ◽

Muscle Involvement ◽

Cutaneous Manifestations ◽

Associated Malignancy ◽

Mechanic’S Hands

Polymyositis and dermatomyositis are two types of idiopathic inflammatory myopathy. The pathological findings in polymyositis suggest an HLA class I-restricted immune response mediated by cytotoxic T cells; dermatomyositis appears to be associated with humorally mediated destruction of muscle-associated microvasculature. Clinical features—polymyositis is characterized by symmetrical painless proximal muscle weakness that develops slowly, usually over weeks to months, and typically associated with significant elevation of serum creatine kinase and other muscle enzymes. The pattern of muscle involvement in dermatomyositis is clinically indistinguishable from that of polymyositis, but with cutaneous manifestations including Gottron’s sign, heliotrope rash, erythema, ‘mechanic’s hands’, periungual abnormalities, and calcinosis cutis. Extra-muscular features include interstitial lung disease (30% of cases), aspiration pneumonia, and associated malignancy (polymyositis 9%, dermatomyositis 15%)....

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Microvascular changes in skeletal muscle in idiopathic inflammatory myopathy

Human Pathology ◽

10.1016/0046-8177(92)90400-w ◽

1992 ◽

Vol 23 (8) ◽

pp. 888-895 ◽

Cited By ~ 34

Author(s):

R. Estruch ◽

J.M. Grau ◽

J. Fernández-Solá ◽

J. Casademont ◽

R. Monforte ◽

...

Keyword(s):

Skeletal Muscle ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

Microvascular Changes

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Idiopathic inflammatory myopathy human derived cells retain their ability to increase mitochondrial function

PLoS ONE ◽

10.1371/journal.pone.0242443 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242443

Author(s):

Carla Basualto-Alarcón ◽

Félix A. Urra ◽

María Francisca Bozán ◽

Fabián Jaña ◽

Alejandra Trangulao ◽

...

Keyword(s):

Skeletal Muscle ◽

Mitochondrial Function ◽

Inflammatory Myopathy ◽

Clinical Manifestations ◽

Metabolic Stress ◽

Idiopathic Inflammatory Myopathy ◽

Therapeutic Interventions ◽

Calcium Handling ◽

Cell Physiology ◽

Atp Production

Idiopathic Inflammatory Myopathies (IIMs) have been studied within the framework of autoimmune diseases where skeletal muscle appears to have a passive role in the illness. However, persiting weakness even after resolving inflammation raises questions about the role that skeletal muscle plays by itself in these diseases. "Non-immune mediated" hypotheses have arisen to consider inner skeletal muscle cell processes as trigger factors in the clinical manifestations of IIMs. Alterations in oxidative phosphorylation, ATP production, calcium handling, autophagy, endoplasmic reticulum stress, among others, have been proposed as alternative cellular pathophysiological mechanisms. In this study, we used skeletal muscle-derived cells, from healthy controls and IIM patients to determine mitochondrial function and mitochondrial ability to adapt to a metabolic stress when deprived of glucose. We hypothesized that mitochondria would be dysfunctional in IIM samples, which was partially true in normal glucose rich growing medium as determined by oxygen consumption rate. However, in the glucose-free and galactose supplemented condition, a medium that forced mitochondria to function, IIM cells increased their respiration, reaching values matching normal derived cells. Unexpectedly, cell death significantly increased in IIM cells under this condition. Our findings show that mitochondria in IIM is functional and the decrease respiration observed is part of an adaptative response to improve survival. The increased metabolic function obtained after forcing IIM cells to rely on mitochondrial synthesized ATP is detrimental to the cell’s viability. Thus, therapeutic interventions that activate mitochondria, could be detrimental in IIM cell physiology, and must be avoided in patients with IIM.

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ASSESSMENT AND MANAGEMENT OF A PATIENT WITH PARANEOPLASTIC DERMATOMYOSITIS

Romanian Journal of Neurology ◽

10.37897/rjn.2017.4.6 ◽

2017 ◽

Vol 16 (4) ◽

pp. 166-169

Author(s):

Ioan-Cristian Lupescu ◽

◽

Adriana Octaviana Dulamea ◽

◽

Keyword(s):

Skeletal Muscles ◽

Inflammatory Myopathy ◽

Elevated Serum ◽

Idiopathic Inflammatory Myopathy ◽

Intravenous Immunoglobulins ◽

Left Breast ◽

Motor Deficits ◽

Muscle Enzymes ◽

Extensive Search ◽

Residual Neoplasm

Dermatomyositis (DM) is an idiopathic inflammatory myopathy, that can be associated with malignancy. We report the case of a 60-years-old woman, diagnosed and treated for left breast cancer, with residual neoplasm following treatment, who was admitted for generalized myalgias and tetraparesis with predominance of paraparesis. Clinical exam revealed heliotrope rash with bilateral palpebral edema and an erythematous eruption on both thighs and anterior thorax. Motor deficits were predominantly proximal. Paraclinical evaluation excluded other etiologies and revealed elevated serum muscle enzymes and electromyographic pattern of myopathy. An MRI was performed and showed diffuse edematous infiltration of skeletal muscles. Symptoms diminished under corticotherapy, intravenous immunoglobulins and cyclophosphamide. Left mastectomy was eventually performed, but DM symptoms reappeared a few months later. Despite extensive search, no recurrence of tumor was found. However, under treatment, the patient once again recovered, and later resumed her activity.

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Comparison of MR T1 and T2 mapping parameters to characterize myocardial and skeletal muscle involvement in systemic idiopathic inflammatory myopathy (IIM)

European Radiology ◽

10.1007/s00330-019-06054-6 ◽

2019 ◽

Vol 29 (10) ◽

pp. 5139-5147 ◽

Cited By ~ 4

Author(s):

Adrian T. Huber ◽

Jérôme Lamy ◽

Marine Bravetti ◽

Khaoula Bouazizi ◽

Tania Bacoyannis ◽

...

Keyword(s):

Skeletal Muscle ◽

T2 Mapping ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

Muscle Involvement ◽

Mapping Parameters ◽

T1 And T2 ◽

Skeletal Muscle Involvement

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Role of Panchakarma in the Management of Masavritavata w.r.t Dermatomyositis - A Case Study

International Journal of Ayurvedic Medicine ◽

10.47552/ijam.v11i4.1666 ◽

2020 ◽

Vol 11 (4) ◽

pp. 780-787

Author(s):

Imtiaz Hossain Md ◽

Mahesh M Parappagoudra ◽

Chimanda L Kamar

Keyword(s):

Immune System ◽

Skeletal Muscles ◽

Inflammatory Myopathy ◽

Signs And Symptoms ◽

Idiopathic Inflammatory Myopathy ◽

Autoimmune Disorder ◽

Muscular Tissue ◽

Small Blood Vessel

Dermatomyositis (DM) is the most frequently occurring Idiopathic Inflammatory Myopathy (IIM) of skeletal muscles causing proximal muscles weakness. The average age at which this disease affects is 40 years and almost twice as many women are affected as men. Its prevalence rate is 2-10 per 1,00,000 in the general population. The actual cause is unknown but the disease has much common with autoimmune disorder in which your immune system mistakenly attacks our body tissue. Small blood vessel in muscular tissue are particularly affected in dermatomyositis. In this disease the ESR and CPK is usually raised. Due to similarity in the signs and symptoms, we can correlate this disease with Mamsavrita-Vata and its treatment can be planned according to it. Here is the case study of 40 years old female patient, diagnosed as Dermatomyositis since 3 months. Patient admitted in Panchakarma ward of Parul Ayurved Hospital, Vadodara. The Panchakarma procedures like Udvartana, Nitya Virechana, Basti Chikitsa, Shasti Shali Pinda Sweda and Shamana Aushadi like Cap Palsineuron and Guduchi Rasayana etc. are given. At the end of the treatment marked improvements were seen in the patient, like reduced ESR and CPK levels. Also the symptoms of the disease reduced significantly.

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Újabb adatok a myositisspecifikus és -asszociált antitestekről juvenilis és felnőttkori myositisekben

Orvosi Hetilap ◽

10.1556/650.2016.30404 ◽

2016 ◽

Vol 157 (30) ◽

pp. 1179-1184 ◽

Cited By ~ 1

Author(s):

Andrea Váncsa ◽

Katalin Dankó

Keyword(s):

Muscle Weakness ◽

Immunosuppressive Treatment ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

General Term ◽

Response To Treatment ◽

Disease Course ◽

Inflammatory Myopathies ◽

Disease Response ◽

Systemic Symptoms

Myositis, which means inflammation of the muscles, is a general term used for inflammatory myopathies. Myositis is a rare idiopathic autoimmune disease. It is believed that environmental factors such as virus, bacteria, parasites, direct injuries, drugs side effect can trigger the immune system of genetically susceptible individuals to act against muscle tissues. There are several types of myositis with the same systemic symptoms such as muscle weakness, fatigue, muscle pain and inflammation. These include dermatomyositis, juvenile dermatomyositis, inclusion-body myositis, polymyositis, orbital myositis and myositis ossificans. Juvenile and adult dermatomyositis are chronic, immune-mediated inflammatory myopathies characterized by progressive proximal muscle weakness and typical skin symptoms. The aim of the authors was to compare the symptoms, laboratory and serological findings and disease course in children and adult patients with idiopathic inflammatory myopathy. Early diagnosis and aggressive immunosuppressive treatment improve the mortality of these patients. Myositis-specific autoantibodies have predictive and prognostic values regarding the associated overlap disease, response to treatment and disease course. The authors intend to lighten the clinical and pathogenetic significance of the new target autoantigens. Orv. Hetil., 2016, 157(29), 1179–1184.

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A rare case of NXP-2 positive dermatomyositis

Archive of Clinical Cases ◽

10.22551/2020.29.0704.10176 ◽

2020 ◽

Vol 7 (4) ◽

pp. 68-71

Author(s):

Nariman Khan ◽

Keyword(s):

Muscle Weakness ◽

Nuclear Matrix ◽

Conventional Therapy ◽

Rare Case ◽

Matrix Protein ◽

Inflammatory Myopathy ◽

Idiopathic Inflammatory Myopathy ◽

Nuclear Matrix Protein ◽

Cutaneous Manifestations ◽

Distal Muscle

Dermatomyositis is an idiopathic inflammatory myopathy with variable cutaneous manifestations. Several autoantibodies each with distinct clinical phenotypes are associated with the disease. Here we present the case of a 36-year-old Laotian woman with hypothyroidism who presented with severe proximal and distal muscle weakness, dysphagia, diffuse rash, and anasarca that was diagnosed with NXP-2 (nuclear matrix protein 2) antibody positive dermatomyositis. The patient’s hospitalization was complicated by disease resistant to conventional therapy.

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