自験封入体筋炎に関する臨床および病理的所見の検討
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Clinicopathological findings and treatmentcourse were analysed on 21 cases of inclusion body myositis. Age at onset was older than in dermatomyositis (DM) and polymyositis (PM), and the duration of illness was longer than in DM. Muscle weakness and atrophy of quadriceps femoris was remarkable, and the frequency of dysphagia was high. Symptoms other than muscle weakness and atrophy were not seen. Serum CK level was elevated mildly or moderately, and the autoantibody concerned with autoimmune myositis was almost negative. It was speculated IBM potentially was related to virus infection including HCV, because HCV antibody was highly positive rate. CT findings of skeletal muscle was in accord with the distribution of muscle weakness, and fatty degeneration of medial head of gastrocnemius was more remarkable. Appearance of rimmed vacuole (RV), infiltration of CD8 positive cytotoxic T cell in and around the non-necrotic cell, and diffuse manifestation of ICAM-1 in muscle fibers were pathological investigated in all cases. In the cases of high frequency of RV, frequency of ragged-red-fibers (RRFs) and neurogenic grouped atrophy were significantly high. There was no correlation between appearance of RV and inflammatory changes. The common etiology relevance as muscular degenerative process was suspected in appearance of RV and RPFs. Serum CK level was normalized with a treatment by oral adrenocorticosteroid treatment, and in same case temporal improvement of symptom was seen. Although its course was slowly progressive, further indication was expected by combination with other treatments.
- 愛知医科大学の論文
- 2004-03-15
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