Baer Alan N
Department of Medicine, Division of Allergy, Immunology, and Rheumatology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, USA.
Curr Rheumatol Rep. 2006 Jun;8(3):178-87. doi: 10.1007/s11926-996-0023-5.
Symmetric proximal muscle weakness has many potential etiologies. An onset over weeks to months and elevated serum levels of muscle enzymes point to the diagnosis of an idiopathic inflammatory myopathy, including dermatomyositis, polymyositis, and inclusion body myositis. However, there is a broad differential diagnosis, including certain muscular dystrophies, metabolic myopathies, drug- or toxin-induced myotoxicity, neuropathies, and infectious myositides. The differentiation is critical for defining appropriate treatment. In addition, an alternative diagnosis may explain the lack of response to immunosuppressive treatment for some patients with polymyositis. Careful clinical evaluation and choice of available diagnostic tests are required to establish the correct diagnosis.
对称性近端肌无力有许多潜在病因。起病数周或数月，且血清肌酶水平升高提示特发性炎性肌病的诊断，包括皮肌炎、多发性肌炎和包涵体肌炎。然而，鉴别诊断范围广泛，包括某些肌肉营养不良症、代谢性肌病、药物或毒素诱导的肌毒性、神经病以及感染性肌炎。这种鉴别对于确定恰当的治疗至关重要。此外，对于一些多发性肌炎患者，另一种诊断可能解释其对免疫抑制治疗缺乏反应的原因。需要进行仔细的临床评估并选择可用的诊断测试来确立正确的诊断。
