Arguelles ZAC, Infante AR, Infante AA, Sánchez BY, Casa FN, Chico CA, Estévez TM , Castell PC

Language: Spanish
References: 34
Page: 6-16
PDF size: 455.00 Kb.

ABSTRACT

Introduction: Polimiositis is a connective tissue disease characterized by the presence of proximal muscular weakness of breathing muscles, myocardium and deglution muscles. When it is associated with skin manifestations it is denominated dermatomiositis.
Objective: To determine the aerobic capacity, muscular force and phosphokreatincinase levels in serum, as well as to carry out the ergometric tests in patients with dermatomiositis/polimiositis suspicion.
Methodology: Descriptive, longitudinal and retrospective study. For the positive diagnosis we were use Bohman and cols criteria. We describe the age and gender at the diagnosis. The aerobic capacity was calculated determining the maximum oxygen consumption according to Balke protocol. Muscular force was evaluated according to the Medical Research Council scale. The determination of phosphokreatincinase levels in serum was carried out using an enzymatic test that determines the enzyme activity in serum. The arterial tension was measured in a manual way with the use of a sphygmomanometer; the heart frequency was measured using a monitor.
Results: The biggest gender frequency corresponded to the feminine one with 63,3 %. The biggest age frequency was the group understood between the 42 and 52 years with 36,4 %. The biggest frequency with regard to the evaluation of the muscular pelvic force corresponded to the 4th grade with 72,7 %. The biggest frequency according to the range of phosphokreatincinase serum concentrations at the moment of diagnosis corresponded to the group with concentration from 0 to 200 UI with 54,5 %. The biggest frequency according to the time of duration of the effort test corresponded to the group from 6,1 to 10 minutes with 72,7 %. The biggest frequency according to the pulse in rest corresponded to the group from 71 to 100 pulsations per minute with 54,6 %. A tendency is observed to a bigger frequency of patient in the ranges of 60-70 and of 71-99 pulsations per minute during the ergometric test, while one observes a tendency to a bigger frequency of patient in the ranges of 71-99 and 100 and more pulsations per minute after the ergometric test. The biggest frequency according to the aerobic capacity measured through the maximum oxygen consumption corresponded to the 17,0-24,4 mL / kg / min group with 45,4 %.
Conclusions: Muscular pelvic force and phosphokreatincinase concentration evaluation constituted an important approaches that allowed to arrive to positive diagnosis. The not total recovery of pulse and of diastolic arterial tension after the ergometric test could be associated to some dysfunction in the regulation mechanisms of pulse frequency and arterial tension. Most of the studied patients present limited capacity in the realization of big efforts.

REFERENCES

1. Bohan A, Peter J. Polymyositis and Dermatomyositis (First of two parts). N Engl J Med. 1975;292(7):344-7. doi: 10.1056. NEJM197502132920706 [PubMed][Cross Ref].

2. Bohan A, Peter J. Polymyositis and Dermatomyositis (Second of two parts). N Engl J Med. 1975;292(8):403-7. doi: 10.1056. NEJM197502202920807.[PubMed][Cross Ref]

3. Restrepo JF. Dermatomiositis-polimiositis. Revista Colombiana de Reumatología. 2003;10(2):135-41.

4. Wagner E. Ein Fall von akuter Polymyositis. Deutsch Arch klin Med. 1886;40:241-66.

5. Unverricht H. Dermatomyositis acuta. Deutsch Med Wchnscher. 1891;17: 41-4.

6. Hofman J. Miopatías Inflamatorias Polimiositis – Dermatomiositis. Reumatología. 2005;21(3):112-5.

7. Secretaría de Salud de México. Diagnóstico y tratamiento de Polimiositis y Dermatomiositis. México DF (México): Secretaría de Salud, 2011.

8. Guenther F, Quittan M, Nuhr M, Vole-Platzer B, Ebenbiche G, Zehetgruber M. Aerobic capacity in adult dermatomyositis/ polimyosytis patients and healthy controls. Arch Phys Med Rehabit. 2000;81:1-5.

9. Institutos Nacionales de Salud. Examen de creatina-fosfocinasa. EE.UU: Biblioteca Nacional de Medicina; 2009.

10. Vargas-Leguás H, Selva-O'Callaghan A, Campins-Martí M, Hermosilla Pérez E, Grau-Junyent JM, Martínez Gómez X, et al. Polymyositis-dermatomyositis: incidence in Spain (1997-2004). Med Clin (Barc). 2007;129:721-4.

11. Pinto P LF, Ángel A AM, Bohórquez A R, López P CM. Caracterización de los pacientes con polimiositis y dermatomiositis del Servicio de Reumatología del Instituto de Seguros Sociales de Medellín, Colombia, 1992-2000. Revista Colombiana de Reumatología. 2003;10(1):9-18.

12. Almanza Liranza Z, Fernández Couce G, Perea Corral J, Quintana Mirabal S, Gómez de Cadiz AT. Dermatomiositis: a propósito de 3 casos interesantes. Rev Cubana Pediatr. 2010;82(4):0-0.

13. Hilton-Jones D. Observations on the classification of the inflammatory myopathies. Presse Med. 2011;40:199-208.

14. Burckhardt CS, Clark SR, Padrick KP. Use of the modified Balke treadmill protocol for determining the aerobic capacity of women with fibromyalgia. Arthritis Care Res. 1989;2(4):165-7.

15. Medical Research Council. Aids to the examination of the peripheral nervous system, Memorandum no. 45. London: Ed. Her Majesty's Stationery Office; 1981.

16. Irazoque-Palazuelos F, Barragán-Navarro Y. Epidemiología, etiología y clasificación. Reumatol Clin. 2009;05 Suppl. 3:2-5.

17. Almanza Liranza Z, Fernández Couce G, Perea Corral J, Quintana Mirabal S, Torres Gómez de Cadiz A. Dermatomiositis: a propósito de 3 casos interesantes. Revista Cubana de Pediatrí. 2010;8(4):104-11.

18. Bernatsky S, Joseph L, Pineau CA, Bélisle P, Boivin JF, Banerjee D, et al. Estimating the prevalence of polymyositis and dermatomyositis from administrative data: age, sex and regional differences. Ann Rheum Dis. 2009;68(7):1192-6.

19. Chávez González N; Sánchez Pérez Y; Elías Montes Y. Dermatomiositis. Presentación de un caso pediátrico. Multimed. 2012;16(1):0-0.

20. Safety and efficacy of exercise training in patients with an idiopathic inflammatory myopathy--a systematic review. Rheumatology (Oxford). 2011;50(11):2113-24.

21. Vázquez del Mercado M, Arana V, Heron M. Alteraciones histológicas y moleculares en miopatías inflamatorias. Reumatol Clin 2009;5:20-2.

22. Greenberg SA. Dermatomyositis and type 1 interferons. Current rheumatology reports. 2010;12(3):198-203.

23. Dimachkie MM. Idiophatic inflammatory myopathies., J Neuroimmunol. 2011;231:32-42.

24. Mammen AL. Dermatomyositis and polymyositis Clinical presentation, autoantibodies and pathogenesis. Ann NY Acad Sci. 2010;1184:134-53.

25. Silva Fernández L, Barbadillo Mateos C, Fernández Castro M, Otón Sánchez T. Los otros biomarcadores. ¿Qué debe saber el reumatólogo? Semin Fund Esp Reumatol. 2011;212: 0-6.

26. Amato AA, Barohn RJ. Evaluation and treatment of inflammatory myophaties. J Neurol Neurosurg Psychiatry 2009; 80: 1060-8.

27. Mann HF, Vencovsky J, Lundberg IE. Treatment-resistant inflammatory myopathy. Best Practice & Research Clinical Rheumatology. 2010;24(3):427-40.

28. Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension durability of blood pressure reduction out to 24 months. Hypertension. 2011;57(5):911-7.

29. Schultz HD, Li YL, Ding Y. Arterial chemoreceptors and sympathetic nerve activity: implications for hypertension and heart failure. Hypertension. 2007;50:6.

30. Harrison DG, Guzik TJ, Lob HE, Madhur MS, Marvar PJ, Thabet SR, Weyand CM. Inflammation, immunity, and hypertension. Hypertension. 2011;57(2),132-40.

31. Guazzi M, Arena R. Pulmonary hypertension with left-sided heart disease. Nature Reviews Cardiology. 2010;7(11):648-59.

32. Hughes JM. Assessing gas exchange. Chron Respir Dis. 2007;4:205-14.

33. Moon RE, Cherry AD, Stolp BW, et al. Pulmonary gas exchange in diving. J Appl Physiol. 2009;106:668-77.

34. Rees SE, Kjaergaard S, Andreassen S, Hedenstierna G. Reproduction of inert gas and oxygenation data: a comparison of the MIGET and a simple model of pulmonary gas exchange. In Applied Physiology in Intensive Care Medicine 1. Berlin: Ed. Springer Heidelberg; 2012:181-8.