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Aktuelle Rheumatologie 2001; 26(6): 260-268
DOI: 10.1055/s-2001-19064
RHEUMATOLOGIE UND NEUROLOGIE
© Georg Thieme Verlag Stuttgart · New York

Myositiden bei rheumatischen Erkrankungen

Myositis in Rheumatic DiseasesC. D. Reimers1 , B. Schlotter-Weigel2
  • 1 Klinik für Neurologie, Sächsisches Krankenhaus Arnsdorf, Arnsdorf
  • 2 Friedrich-Baur-Institut, Ludwig-Maximilians-Universität München, München
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Publication History

Publication Date:
17 December 2001 (online)

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Zusammenfassung

Myalgien sind sehr häufige Symptome rheumatischer Erkrankungen. Als Folge einer schmerzbedingten Minderinnervation kann eine Muskelschwäche bestehen. Bei bis zu jedem vierten Patienten besteht eine histopathologisch gesicherte Myositis, besonders häufig beim Anti-Synthetase-Syndrom (83 - 94 %), bei der mixed connective tissue disease (50 - 80 %), seltener bei systemischer Sklerose (5 - 17 %) und systemischem Lupus erythematodes (4 - 16 %), Sjögren-Syndrom (2,5 - 10 %) und als Rarität bei rheumatoider Arthritis (ca. 2 %), Wegener-Granulomatose und Churg-Strauss-Syndrom. Die Myositis ähnelt klinisch und histopathologisch vielfach einer idiopathischen Poly- oder Dermatomyositis, daneben kommen blandere, herdförmige entzündliche Infiltrate vor. Eine erhöhte Aktivität der Muskelenzyme, elektromyographische Veränderungen und der kernspintomographische Nachweis von Muskelödem sind unspezifische Hinweise auf die Muskelaffektion. Je nach Grunderkrankung lassen sich vaskulitische Veränderungen darstellen. Die Therapie und Prognose der Myositis werden entscheidend von der Grundkrankheit bestimmt. Die vorliegende Übersicht präsentiert die Symptomatik sowie das diagnostische und therapeutische Procedere bei Myositiden im Rahmen rheumatischer Grundkrankheiten.

Myositis in Rheumatic Diseases

In rheumatic diseases, muscle pain is a frequent complaint. Muscular disuse can be accompanied by weakness. On the whole, up to every fourth patient suffers from histopathologically confirmed myositis, especially often in anti-synthetase syndromes (83 - 94 %), mixed connective tissue disease (50 - 80 %), and more rarely in systemic sclerosis (5 - 17 %), systemic lupus erythematosus (4 - 16 %), Sjögren’s syndrome (2.5 - 10 %), rheumatoid arthritis (ca. 2 %), Wegener’s granulomatosis, and Churg-Strauss syndrome; this myositis may clinically and histopathologically resemble idiopathic poly- and dermatomyositis, whereas milder, focal inflammatory infiltrates may also occur. Increased activity of muscle enzymes, electromyographical abnormalities, and magnetic resonance tomographic evidence of muscle oedema are non-specific hints of muscle involvement. Depending on the type of rheumatic disease intramuscular vasculitis can be identified. Therapy and prognosis of myositis also mainly depend on the underlying disease. This review deals with symptoms as well as diagnostic and therapeutic procedures in myositis due to rheumatic diseases.

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Prof. Dr. med. C. D. Reimers

Klinik für Neurologie, Sächsisches Krankenhaus Arnsdorf

Postfach 1165
01475 Arnsdorf

Email: carl.reimers@skhar.sms.sachsen.de