Carpenter S, Karpati G, Heller I, Eisen A
Neurology. 1978 Jan;28(1):8-17. doi: 10.1212/wnl.28.1.8.
We report six cases of inclusion body myositis (IBM), a distinct but infrequently recognized inflammatory disease of skeletal muscle. Clinically, IBM differs from dermatomyositis and polymyositis. It lacks features of collagen-vascular disease, has a relatively benign and protracted course, frequently involves distal muscles, is found mainly in males, and does not improve with corticosteroid treatment. Electronmicroscopic demonstration of abnormal filaments in muscle cells is necessary for definite diagnosis, but IBM may be suspected by the finding on cryostat sections of numerous hematoxylinophilic granules in "lined" vacuoles in muscle cells. These correspond to whorls of cytomembranes. Although in dermatomyositis the capillary network is partly destroyed, in IBM it is usually augmented. A viral etiology of IBM has been suggested but remains unproven.
我们报告了6例包涵体肌炎（IBM），这是一种独特但鲜被认识的骨骼肌炎性疾病。临床上，IBM不同于皮肌炎和多发性肌炎。它缺乏胶原血管病的特征，病程相对良性且迁延，常累及远端肌肉，主要见于男性，且皮质类固醇治疗无效。肌肉细胞中异常细丝的电镜显示对明确诊断是必要的，但通过冷冻切片发现肌肉细胞“衬里”空泡中有许多苏木精嗜染颗粒，可能怀疑为IBM。这些颗粒对应于细胞膜的涡旋。虽然在皮肌炎中毛细血管网部分被破坏，但在IBM中通常是增多的。有人提出IBM的病因是病毒，但尚未得到证实。
