Polymyositis

Diagnosis

If you have polymyositis, your doctor may recommend one or more of the following tests:

• Blood tests. Your doctor can determine if you have damaged muscles by measuring the levels of muscle enzymes in your blood, which can be detected through a blood test. The optimal drug and course of treatment can be chosen based on the specific autoantibodies that are linked to certain polymyositis symptoms that can be found through a blood test.
• Electromyography. A tiny needle electrode is inserted into the muscle during this test through the skin. When you relax or contract a muscle, electrical activity is recorded, and variations in the electrical activity’s pattern can identify a muscle ailment. By examining several muscles, the doctor can ascertain where the sickness is most prevalent.
• Biopsy. During a biopsy, a small sample of muscle tissue is surgically removed and sent to a laboratory for examination. The results of the analysis can reveal abnormalities such as inflammation, damage, deficiencies in specific proteins or enzyme.
• Magnetic Resonance Imaging (MRI). An MRI scanner utilizes a strong magnetic field and radio waves to generate detailed, cross-sectional images of your muscles. Unlike a muscle biopsy, an MRI may be able to detect inflammation over a larger area of muscle tissue.

Treatment

Although polymyositis cannot be cured, treatment can increase your muscle power and functionality. The earlier polymyositis is treated, the more effective the treatment is likely to be, and the fewer complications are likely to arise.

There is no one method that works best for every disease, so your doctor will customize your care based on your symptoms and how well they react to therapy.

Medications

The following drugs are commonly used in the treatment of polymyositis:

• Corticosteroids. Symptoms of polymyositis can be effectively managed with the help of medications like prednisone. However, continuous use of these medications can have severe side effects that can affect many different body systems. For this reason, your doctor may gradually decrease the medicine dose to lower levels.
• Corticosteroid-sparing agents. These medications can reduce the dose and potential negative effects of a corticosteroid when used in conjunction with it. Polymyositis is commonly treated with two drugs, namely azathioprine and methotrexate. Other medications that may be prescribed for the condition include tacrolimus, cyclosporine, and mycophenolate mofetil.
• Rituximab. Rituximab is a choice if your polymyositis symptoms are not sufficiently controlled by first therapy. It is more frequently used to treat rheumatoid arthritis.

Therapy

Depending on the severity of your symptoms, your doctor may recommend the following measures:

• Physical therapy. A physical therapist can recommend a suitable level of activity and demonstrate exercises to maintain and increase your strength and flexibility.
• Speech therapy. If polymyositis causes weakness in the muscles that control your ability to swallow, speech therapy can teach you how to adjust to these changes.
• Dietetic assessment. As polymyositis advances, it may become more difficult to swallow and chew. In such cases, a certified dietician can assist you in preparing nutritious, easy-to-prepare meals.

Other procedures

Intravenous Immunoglobulin (IVIg) is a purified blood product that contains healthy antibodies from numerous blood donors. These antibodies can block the harmful ones that attack muscles in polymyositis. Since IVIg is administered intravenously, its effects may be temporary and may require repeated treatments to maintain its efficacy.