tailieunhanh - Atlas of Neuromuscular Diseases - part 9

Đối với một hội chứng không liên quan đến virus HIV, bệnh thường tự giới hạn và tiên lượng là tốt. Trường hợp có HIV nhiễm trùng hoặc nhiễm trùng cơ hội tiên lượng kém. Loại bỏ các ký sinh trùng bị cô lập cùng với thuốc chống protozoal có thể là tất cả những gì là cần thiết để điều trị viêm cơ | 379 drugs patients may require surgical drainage of the abscess or removal of the parasite. HIV polymyositis is similar to disease in non-HIV patients and may improve with corticosteroids or immunosuppressive medications. Some patients with the HIV wasting disorder may respond to oxandrolone. The prognosis depends on the specific cause of the myositis. For a non-HIV Prognosis related viral syndrome the disease is usually self-limiting and prognosis is good. Where there is HIV infection or opportunistic infection the prognosis is poor. Removal of isolated parasites coupled with anti-protozoal medications may be all that is required to treat parasitic myositis. Banker BQ 1994 Parasitic myositis in myology. In Engel AJ Franzini-Armstrong C eds References McGraw Hill New York pp 1453-1455 Chimelli L Silva BE 2001 Viral myositis in structural and molecular basis of skeletal muscle diseases. In Karpati G ed ISN Neuropathology Press Basel pp 231-235 Dalakas MC 1994 Retrovirus-related muscle diseases in myology. In Engel AJ Franzini-Armstrong C eds McGraw Hill New York pp 1419-1437 380 Duchenne muscular dystrophy DMD Genetic testing NCV EMG Laboratory Imaging Biopsy - Fig. 12. Muscle biopsy DMD. A Hematoxylin and eosin showing an increase in endomysial connective tissue large arrows inflammatory infiltrates small arrows and degenerating fibers arrow head . B Normal dystrophin staining. C Loss of dystrophin staining in DMD Distribution Time course Onset age Clinical syndrome Proximal muscles are more affected than distal muscles. Infants may have generalized hypotonia and be described as floppy . Progressive disorder resulting in significant disability in most children. DMD starts at age 3-5 years with symmetric proximal greater than distal weakness in the arms and legs. By 6-9 years they characteristically exhibit a positive Gower s sign and by 10-12 years patients often fail to walk. DMD results in a progressive muscular weakness affecting 1 3500 male infants. They often