tailieunhanh - Atlas of Neuromuscular Diseases A Practical Guideline - part 9

bệnh nhân có thể yêu cầu phẫu thuật thoát nước của áp xe, hoặc loại bỏ ký sinh trùng. HIV polymyositis tương tự như bệnh ở bệnh nhân không nhiễm HIV và có thể cải thiện với corticosteroid hoặc thuốc ức chế miễn dịch. Một số bệnh nhân với các rối loạn lãng phí HIV | 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 This is trial version 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 Proximal muscles are more affected than distal muscles. Infants may have generalized hypotonia and be described as floppy . Time course Progressive disorder resulting in significant disability in most children. Onset age 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. Clinical syndrome DMD results in a progressive muscular weakness .