Myositis: A quick take by Dr Kashyap Dakshini

Last Updated on November 26, 2022 by Neelam Singh

Myositis is a group of rare health conditions that affect muscles. Recently, Myositis surfaced in the news when a popular South Indian Actress, Samantha Ruth Prabhu discussed her recovery from this condition in a social media post. 

Myositis is comparatively a lesser known condition among common people. To understand about this condition, THIP media reached out to Dr Kashyap Dakshini, General Physician practising in Mumbai, and had an educative discussion about Myositis.

Dr Kashyap Dakshini has over two and half decades of experience of working with different hospitals and corporates. Dr Kashyap is also a part of the managing committee of IMA, Mumbai and a member of the Indian Association of Occupational Health and General Practitioners.

What causes Myositis? Is it a serious health condition?

Myositis is the inflammation of muscles, which causes muscle weakness and difficulty in their movement. It is of two major types; one is primary myositis another is secondary myositis. Primary myositis is referred to as dermato-myositis, an inflammation of skin as well as the muscles. Since it is an auto-immune disease, the immune system of the body starts attacking the muscles of the body. In secondary myositis, there can be various other causes like infections, drugs, rheumatological diseases or malignancies. Various bacterial, viral, fungal or parasitic infections can also cause secondary myositis. Similarly, drugs used for cancer treatment, chloroquine, hydroxychloroquine, etc., may also cause myositis. Certain rheumatological conditions like Lupus (SLE) or connective tissue disorders can also lead to myositis. In some cases, cancer can coexist or cause myositis.

How is myositis diagnosed? Can a simple blood test suspect a person of myositis?

It is a very serious disease, and at the same time, it’s very rare to diagnose. Clinicians don’t commonly think of myositis as a straightforward diagnosis except for a rheumatologist as it is their speciality. So, myositis is not a part of the first list of differential diagnoses, and so it remains undiagnosed in about 95% of patients suffering from myositis.

Since myositis is the inflammation of muscles, the symptoms like difficulty in getting up from a sitting position from a chair or the floor, difficulty in swallowing, etc., together can give us a suspicion for myositis. The main symptoms of myositis is proximal muscle weakness, which is in the muscles towards the main axis of the body, such as shoulders, thighs, food pipe muscles, diaphragm, etc.

In the cases of dermato-myositis, there are rashes on the face, chest, etc. So, these clinical symptoms grouped together can lead to suspicion of myositis. However, there are certain tests to diagnose myositis like creatine kinase test (a blood test), electromyography (EMG) as well as an MRI. A muscle biopsy is a conclusive test to diagnose myositis. 

How common myositis is in India? Is it a gender-specific disease?

Myositis is a rare condition. And the exact epidemiology of myositis is not being studied in India and even worldwide. There is very limited information available on this. However, one study using the administrative claims data in Canada in which there were about seven and a half billion beneficiaries found that there is an estimated prevalence of approximately 21 to 22 cases per hundred thousand population for dermato-myositis and polymyositis. And the overall prevalence of all types of myositis is approximately 14 to 22 per hundred thousand population. Also, there is similar prevalence of the condition in both males and females.

How is myositis treated? Does diet have a role to play in recovering from myositis?

For treatment, firstly the type of myositis has to be identified. In the cases of primary myositis, physical exercise, physiotherapy, strengthening muscles, speech therapy (if the condition is affecting the speech muscles) can be done to treat the condition. Along with this, strong medication including steroids and other drugs are used for the treatment.

In the cases of secondary myositis, the treatment of the underlying cause like infections, cancers, rheumatological diseases, etc., would lead to the resolution of myositis. Similarly, if the myositis is caused due to any drug, then the withdrawal of that drug would also resolve the symptoms of the condition.

Although diet is not directly linked with the treatment of myositis, consumption of protein would lead to some kind of muscle generation. A high protein diet would definitely support the treatment of the condition.

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