Department of Neurology, Muscle Immunobiology Group, Neuromuscular Center, University Medical Center Göttingen, Robert-Koch-Sr. 40, 37075, Göttingen, Germany.
Curr Rheumatol Rep. 2020 Aug 28;22(10):74. doi: 10.1007/s11926-020-00950-3.
Dysphagia is a common symptom in inflammatory myopathies. This review provides an overview on the epidemiology, clinical impact, and management of dysphagia in myositis. Relevant diagnostic tools and treatment strategies are discussed.
Dysphagia can occur in any inflammatory myopathy, particularly in inclusion body myositis (IBM). It can lead to malnutrition or aspiration with subsequent pneumonia or even death. Dysphagia can be explored and monitored by patient-reported outcome scales for swallowing. New diagnostic tools such as real-time MRI and oro-pharyngo-esophageal scintigraphy have been studied for assessing dysphagia. Botulinum toxin injection can alleviate dysphagia in IBM. High-dose glucocorticosteroids are considered a first-line treatment for dysphagia in all other myositis subforms. Evaluation of dysphagia in myositis requires thorough clinical workup and appropriate instrumental procedures. Treatment options are available for dysphagia, but controlled trials and consensus on best patient care are required for this important symptom.
吞咽困难是炎性肌病的常见症状。本文就肌炎患者吞咽困难的流行病学、临床影响和管理进行综述,讨论相关的诊断工具和治疗策略。
吞咽困难可发生于任何炎性肌病,尤其在包涵体肌炎(IBM)中。吞咽困难可导致营养不良或误吸,进而引起肺炎,甚至死亡。吞咽困难可通过吞咽患者报告结局量表进行评估和监测。新型诊断工具,如实时 MRI 和口腔-咽-食管闪烁扫描,已被用于评估吞咽困难。肉毒毒素注射可缓解 IBM 患者的吞咽困难。对于其他类型的肌炎,大剂量糖皮质激素被认为是吞咽困难的一线治疗药物。肌炎患者的吞咽困难评估需要进行全面的临床检查和适当的仪器检查。吞咽困难有多种治疗选择,但对于这一重要症状,仍需要开展对照试验和制定最佳患者管理共识。