Muscle biopsy features of idiopathic inflammatory myopathies and differential diagnosis

Massimiliano Mirabella, Matteo Lucchini, Gaetano Vattemi, Valeria Guglielmi, Giuliano Tomelleri, Anna Ghirardello, Andrea Doria

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

40 Citazioni (Scopus)

Abstract

The gold standard to characterize idiopathic inflammatory myopathies is the morphological, immunohistochemical and immunopathological analysis of muscle biopsy. Mononuclear cell infiltrates and muscle fiber necrosis are commonly shared histopathological features. Inflammatory cells that surround, invade and destroy healthy muscle fibers expressing MHC class I antigen are the typical pathological finding of polymyositis. Perifascicular atrophy and microangiopathy strongly support a diagnosis of dermatomyositis. Randomly distributed necrotic muscle fibers without mononuclear cell infiltrates represent the histopathological hallmark of immune-mediated necrotizing myopathy; meanwhile, endomysial inflammation and muscle fiber degeneration are the two main pathological features in sporadic inclusion body myositis. A correct differential diagnosis requires immunopathological analysis of the muscle biopsy and has important clinical implications for therapeutic approach. In particular, unnecessary, potentially harmful, immune-suppressive therapy should be avoided alike in dystrophic myopathies with secondary inflammation.
Lingua originaleEnglish
pagine (da-a)77-85
Numero di pagine9
RivistaAutoimmunity Highlights
Volume5
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Autoimmune myositis
  • Differential diagnosis
  • Histopathology
  • Inflammatory myopathy

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