Prasad M L, Sarkar C, Roy S, Bagchi U, Singh R R, Singh Y N, Sharma S, Malaviya A N
Department of Pathology, All India Institute of Medical Sciences, New Delhi.
Br J Rheumatol. 1992 Dec;31(12):835-9. doi: 10.1093/rheumatology/31.12.835.
The present study attempts to investigate the pathological basis of the two clinically different forms of idiopathic inflammatory myopathy (IIM) namely, polymyositis (PM) and dermatomyositis (DM). Clinicopathological analysis of 73 cases showed that muscle fibre necrosis and regeneration were more frequent in PM than in DM, the latter being significantly so (P < 0.05). On the other hand, vasculitis was more associated with DM while perifascicular atrophy of the muscle fibres was confined to it. Vasculitis was present in eight cases. Its incidence in patients with myositis with systemic connective tissue disease (4/9) was significantly more than in other PM and DM patients (P < 0.01). An equally significant higher frequency of perimysial inflammatory infiltrate was also seen in the former as compared to the latter. Interestingly, idiopathic DM affected men as often as women and juvenile IIM affected boys more frequently than girls. A female predilection was noted in the remaining groups of IIM. These observations indicate that there may be some basic immunopathogenetic differences between polymyositis and dermatomyositis as well as between idiopathic PM/DM and that associated with systemic connective tissue diseases. Though the number of patients studied is small, the absence of female predilection in idiopathic DM and juvenile IIM may be peculiar to the IIM in the tropics.
本研究试图探究两种临床症状不同的特发性炎性肌病（IIM），即多发性肌炎（PM）和皮肌炎（DM）的病理基础。对73例患者的临床病理分析表明，PM中肌纤维坏死和再生比DM更常见，后者差异显著（P<0.05）。另一方面，血管炎与DM的相关性更强，而肌纤维束周萎缩仅见于DM。有8例出现血管炎。其在合并系统性结缔组织病的肌炎患者中的发生率（4/9）显著高于其他PM和DM患者（P<0.01）。与后者相比，前者肌束膜炎性浸润的频率同样显著更高。有趣的是，特发性DM对男性和女性的影响相同，而青少年IIM对男孩的影响比对女孩更频繁。在其余IIM组中观察到女性易感性。这些观察结果表明，PM和DM之间以及特发性PM/DM与合并系统性结缔组织病的IIM之间可能存在一些基本的免疫发病机制差异。尽管研究的患者数量较少，但特发性DM和青少年IIM中缺乏女性易感性可能是热带地区IIM所特有的。
