Polymyositis: The Daily PANCE Blueprint

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Polymyositis: The Daily PANCE Blueprint

A 48-year-old woman presents with progressive proximal muscle weakness, difficulty climbing stairs, and rising from a seated position. She denies any rash. Laboratory testing reveals elevated creatine kinase and aldolase levels. Electromyography is consistent with an inflammatory myopathy. A muscle biopsy is performed. Which of the following histopathological findings is most characteristic of this condition?

A. Atrophy of the epimysial layer
B. Abundance of anti-M2 antibodies
C. Vascular inflammation
D. Perifascicular hypertrophy
E. Endomysial inflammation

Answer and topic summary

The answer is E. Endomysial inflammation

Polymyositis is a type of idiopathic inflammatory myopathy characterized by symmetrical proximal muscle weakness. It usually develops over weeks or months. Patients may also experience myalgias, dysphagia, and fatigue. Patients will have an elevated creatinine phosphokinase, an abnormal EMG, and a muscle biopsy that shows inflammation / muscle fiber fibrosis (within the endomysial layer of the skeletal muscle). Initial treatment is corticosteroids and physical therapy.

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Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Rheumatologic Disorders ⇒ Polymyositis

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