Acquired immune and inflammatory myopathies: pathologic classification.

Abstract:

PURPOSE OF REVIEW:We discuss pathology-based characterization and classification of acquired immune and inflammatory myopathies (IIMs). RECENT FINDINGS:Several types of IIMs do not fit well into the typical IIM subclassifications: dermatomyositis, polymyositis and inclusion body myositis (IBM). Myopathologic features that can provide additional diagnostic clarification in IIM are types of muscle fiber pathology; immune changes (cellular and humoral); and tissues with distinctive involvement (connective tissue, vessels and muscle fibers). Pathologic classification categories include immune myopathies with perimysial pathology (IMPP), a group that can be associated with antisynthetase antibodies; myovasculopathies, including childhood dermatomyositis; immune polymyopathies, active myopathies with little inflammation such as the myopathy with signal recognition particle antibodies; immune myopathies with endomysial pathology (IM-EP), illustrated by brachio-cervical inflammatory myopathy (BCIM); histiocytic inflammatory myopathies, like sarcoid myopathy; and inflammatory myopathies with vacuoles, aggregates and mitochondrial pathology (IM-VAMP), which have inclusion body myositis as a pathologic subtype and are poorly treatable. Some myopathologic features, like B-cell foci and alkaline phosphatase staining of capillaries or perimysium, are more likely to be present in treatable categories of IIM. SUMMARY:Myopathology can be used to classify IIM. Identification of distinctive myopathologic changes in IIM can improve diagnostic and prognostic accuracy and focus treatment, therapeutic trials and studies of pathogenic factors.

journal_name

Curr Opin Rheumatol

authors

Pestronk A

doi

10.1097/BOR.0b013e32834bab42

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

595-604

issue

6

eissn

1040-8711

issn

1531-6963

journal_volume

23

pub_type

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