Finsterer J, Löscher W N, Wanschitz J, Quasthoff S, Grisold W
Krankenanstalt Rudolfstiftung, Vienna, Austria.
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Acta Neurol Scand. 2016 Dec;134(6):388-402. doi: 10.1111/ane.12576. Epub 2016 Feb 25.
Some systemic diseases also affect the skeletal muscle to various degrees and with different manifestations. This review aimed at summarizing and discussing recent advances concerning the management of muscle disease in systemic diseases.
Literature review by search of MEDLINE, and Current Contents with appropriate search terms.
Secondary muscle disease occurs in infectious disease, endocrine disorders, metabolic disorders, immunological disease, vascular diseases, hematological disorders, and malignancies. Muscle manifestations in these categories include pathogen-caused myositis, muscle infarction, rhabdomyolysis, myasthenia, immune-mediated myositis, necrotising myopathy, or vasculitis-associated myopathy. Muscle affection may concern only a single muscle, a group of muscles, or the entire musculature. Severity of muscle affection may be transient or permanent, may be a minor part of or may dominate the clinical picture, or may be mild or severe, requiring invasive measures including artificial ventilation if the respiratory muscles are additionally involved. Diagnostic work-up is similar to that of primary myopathies by application of non-invasive and invasive techniques. Treatment of muscle involvement in systemic diseases is based on elimination of the underlying cause and supportive measures. The prognosis is usually fair if the causative disorder is effectively treatable but can be fatal in single cases if the entire musculature including the respiratory muscles is involved, in case of infection, or in case of severe rhabdomyolysis.
Secondary muscle manifestations of systemic diseases must be addressed and appropriately managed. Prognosis of secondary muscle disease in systemic diseases is usually fair if the underlying condition is accessible to treatment.
一些全身性疾病也会不同程度地影响骨骼肌，且表现各异。本综述旨在总结和讨论全身性疾病中肌肉疾病管理方面的最新进展。
通过使用适当的检索词检索医学文献数据库（MEDLINE）和《现刊目次》进行文献综述。
继发性肌肉疾病发生于传染病、内分泌失调、代谢紊乱、免疫性疾病、血管疾病、血液系统疾病及恶性肿瘤。这些类别的肌肉表现包括病原体引起的肌炎、肌肉梗死、横纹肌溶解、肌无力、免疫介导性肌炎、坏死性肌病或血管炎相关肌病。肌肉受累可能仅涉及单个肌肉、一组肌肉或整个肌肉系统。肌肉受累的严重程度可能是短暂的或永久性的，可能是临床症状的次要部分或主导部分，也可能是轻度或重度的，如果呼吸肌也受累，则可能需要包括人工通气在内的侵入性措施。通过应用非侵入性和侵入性技术进行诊断检查与原发性肌病相似。全身性疾病中肌肉受累的治疗基于消除潜在病因和支持性措施。如果致病疾病可有效治疗，预后通常较好，但如果整个肌肉系统包括呼吸肌受累、发生感染或严重横纹肌溶解，个别情况下可能致命。
全身性疾病的继发性肌肉表现必须得到关注并进行适当管理。如果潜在疾病可治疗，全身性疾病中继发性肌肉疾病的预后通常较好。
