Acquired immune and inflammatory myopathies: pathologic classification.

Abstract

PURPOSE OF REVIEW:

We discuss pathology-based characterization and classification of acquired immune and inflammatory myopathies (IIMs).

RECENT FINDINGS:

Several types of IIMs do not fit well into the typical IIM subclassifications: dermatomyositis, polymyositis and inclusion body myositis (IBM). Myopathologic features that can provide additional diagnostic clarification in IIM are types of muscle fiber pathology; immune changes (cellular and humoral); and tissues with distinctive involvement (connective tissue, vessels and muscle fibers). Pathologic classification categories include immune myopathies with perimysial pathology (IMPP), a group that can be associated with antisynthetase antibodies; myovasculopathies, including childhood dermatomyositis; immune polymyopathies, active myopathies with little inflammation such as the myopathy with signal recognition particle antibodies; immune myopathies with endomysial pathology (IM-EP), illustrated by brachio-cervical inflammatory myopathy (BCIM); histiocytic inflammatory myopathies, like sarcoid myopathy; and inflammatory myopathies with vacuoles, aggregates and mitochondrial pathology (IM-VAMP), which have inclusion body myositis as a pathologic subtype and are poorly treatable. Some myopathologic features, like B-cell foci and alkaline phosphatase staining of capillaries or perimysium, are more likely to be present in treatable categories of IIM.

SUMMARY:

Myopathology can be used to classify IIM. Identification of distinctive myopathologic changes in IIM can improve diagnostic and prognostic accuracy and focus treatment, therapeutic trials and studies of pathogenic factors.

• Authors: Alan Pestronk
• Journal: Current opinion in rheumatology (Curr Opin Rheumatol) Vol. 23 Issue 6 Pg. 595-604 (Nov 2011) ISSN: 1531-6963 [Electronic] United States
• PMID: 21934500 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Topics

• Dermatomyositis (pathology)
• Histiocytes (pathology)
• Humans
• Mitochondria, Muscle (pathology)
• Muscle Fibers, Skeletal (pathology)
• Myositis (classification, immunology, pathology)
• Myositis, Inclusion Body (pathology)
• Polymyositis (pathology)
• Vacuoles (pathology)