関: musculoskeletal disease

WordNet

an impairment of health or a condition of abnormal functioning
make ones way by force; "He muscled his way into the office"
animal tissue consisting predominantly of contractile cells (同)muscular_tissue
one of the contractile organs of the body (同)musculus
authority or power or force (especially when used in a coercive way); "the senators used their muscle to get the party leader to resign"
caused by or altered by or manifesting disease or pathology; "diseased tonsils"; "a morbid growth"; "pathologic tissue"; "pathological bodily processes" (同)morbid, pathologic, pathological

PrepTutorEJDIC

(体の)『病気』,疾患 / (精神・道徳などの)病気,病弊
女性の話術芸人 =diseur
〈U〉(動物体の組織としての)『筋肉』,筋(きん);〈C〉(体の各部を動かす)筋肉 / 〈U〉力,(特に)筋力,腕力 / 《俗に》(…に)強引に割り込む《+『in on』(『into, through』)+『名』》
病気にかかった / 病的な,不健全な(morbid)
筋肉の,筋力のある / 力ずくの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/03/13 00:42:16」(JST)

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In medicine, a myopathy is a muscular disease^[1] in which the muscle fibers do not function for any one of many reasons, resulting in muscular weakness. "Myopathy" simply means muscle disease (myo- Greek μυο "muscle" + pathos -pathy Greek "suffering"). This meaning implies that the primary defect is within the muscle, as opposed to the nerves ("neuropathies" or "neurogenic" disorders) or elsewhere (e.g., the brain etc.). Muscle cramps, stiffness, and spasm can also be associated with myopathy.

Muscular disease can be classified as neuromuscular or musculoskeletal in nature. Some conditions, such as myositis, can be considered both neuromuscular and musculoskeletal.

Myopathy in Systemic Diseases

Myopathies in systemic disease results from several different disease processes including endocrine, inflammatory, paraneoplastic, infectious, drug- and toxin-induced, critical illness myopathy, metabolic, and myopathies with other systemic disorders. Patients with systemic myopathies often present acutely or sub acutely. On the other hand, familial myopathies or dystrophies generally present in a chronic fashion with exceptions of metabolic myopathies where symptoms on occasion can be precipitated acutely. Most of the inflammatory myopathies can have a chance association with malignant lesions; the incidence appears to be specifically increased only in patients with dermatomyositis.^[2]

Classes

There are many types of myopathy. ICD-10 codes are provided here where available.

Inherited forms

(G71.0) Dystrophies (or muscular dystrophies) are a subgroup of myopathies characterized by muscle degeneration and regeneration. Clinically, muscular dystrophies are typically progressive, because the muscles' ability to regenerate is eventually lost, leading to progressive weakness, often leading to use of a wheelchair, and eventually death, usually related to respiratory weakness.
(G71.1) Myotonia
- Neuromyotonia
(G71.2) The congenital myopathies do not show evidence for either a progressive dystrophic process (i.e., muscle death) or inflammation, but instead characteristic microscopic changes are seen in association with reduced contractile ability of the muscles. Congenital myopathies include, but are not limited to:
- (G71.2) nemaline myopathy (characterized by presence of "nemaline rods" in the muscle),
- (G71.2) multi/minicore myopathy (characterized by multiple small "cores" or areas of disruption in the muscle fibers),
- (G71.2) centronuclear myopathy (or myotubular myopathy) (in which the nuclei are abnormally found in the center of the muscle fibers), a rare muscle wasting disorder
(G71.3) Mitochondrial myopathies, which are due to defects in mitochondria, which provide a critical source of energy for muscle
(G72.3) Familial periodic paralysis
(G72.4) Inflammatory myopathies, which are caused by problems with the immune system attacking components of the muscle, leading to signs of inflammation in the muscle
(G73.6) Metabolic myopathies, which result from defects in biochemical metabolism that primarily affect muscle
- (G73.6/E74.0) Glycogen storage diseases, which may affect muscle
- (G73.6/E75) Lipid storage disorder

Acquired

(G72.0 - G72.2) External substance induced myopathy
- (G72.0) Drug-induced myopathy
  - Glucocorticoid myopathy is caused by this class of steroids increasing the breakdown of the muscle proteins leading to muscle atrophy.^[3]
- (G72.1) Alcoholic myopathy
- (G72.2) Myopathy due to other toxic agents
(M33.0-M33.1)
- Dermatomyositis produces muscle weakness and skin changes. The skin rash is reddish and most commonly occurs on the face, especially around the eyes, and over the knuckles and elbows. Ragged nail folds with visible capillaries can be present. It can often be treated by drugs like corticosteroids or immunosuppressants. (M33.2)
- Polymyositis produces muscle weaknesss. It can often be treated by drugs like corticosteroids or immunosuppressants.
- Inclusion body myositis is a slowly progressive disease that produces weakness of hand grip and straightening of the knees. No effective treatment is known.
(M61) Myositis ossificans
(M62.89) Rhabdomyolysis and (R82.1) myoglobinurias

The Food and Drug Administration is recommending that physicians restrict prescribing high-dose Simvastatin (Zocor, Merck) to patients, given an increased risk of muscle damage. The FDA drug safety communication stated that physicians should limit using the 80-mg dose unless the patient has already been taking the drug for 12 months and there is no evidence of myopathy. "Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug," the agency states.

Differential diagnosis of systemic myopathy based on age of onset^[4]

Myopathies presenting at birth:- None as systemic causes; mainly hereditary

Myopathies presenting in childhood:-

Inflammatory myopathies – dermatomyositis, polymyositis (rarely)

Infectious myopathies

Endocrine and metabolic disorders – hypokalemia, hypocalcemia, hypercalcemia

Myopathies presenting in adulthood

Inflammatory myopathies – polymyositis, dermatomyositis, inclusion body myositis, viral (HIV)

Infectious myopathies

Endocrine myopathies – thyroid, parathyroid, adrenal, pituitary disorders

Toxic myopathies – alcohol, corticosteroids, narcotics, colchicines, chloroquine

Critical illness myopathy

Metabolic myopathies

Paraneoplastic myopathy

Symptoms

Common muscle weakness. Also (R25.2) cramps (M25.6) stiffness, and (R29.0) tetany

Treatments

Because different types of myopathies are caused by many different pathways, there is no single treatment for myopathy. Treatments range from treatment of the symptoms to very specific cause-targeting treatments. Drug therapy, physical therapy, bracing for support, surgery, massage, and even acupuncture are all current treatments for a variety of myopathies.

References

^ "Myopathy - Definition from the Merriam-Webster Online Dictionary". http://www.merriam-webster.com/dictionary/Myopathy.
^ Chawla, Jasvinder. "Stepwise Approach to Myopathy in Systemic Disease". Front Neurol. 2011; 2: 49. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153853/. Retrieved 4 May 2012.
^ Seene T (July 1994). "Turnover of skeletal muscle contractile proteins in glucocorticoid myopathy". J. Steroid Biochem. Mol. Biol. 50 (1-2): 1–4. doi:10.1016/0960-0760(94)90165-1. PMID 8049126.
^ "Sytemic Myopathy". http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153853/table/T6/. Retrieved 4 May 2012.

External links

GeneReviews/NCBI/NIH/UW entry on Myopathy with Deficiency of ISCU
See http://neuromuscular.wustl.edu/ for medical descriptions.

UpToDate Contents

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1. 筋力低下患者へのアプローチ approach to the patient with muscle weakness
2. 全身性疾患のミオパシー myopathies of systemic disease
3. 代謝性ミオパチーへのアプローチ approach to the metabolic myopathies
4. 薬物誘導性ミオパシー drug induced myopathies
5. 先天性ミオパシー congenital myopathies

English Journal

[Autophagic vacuolar myopathies: what we have learned from the differential diagnosis of vacuoles in muscle biopsy].

Zámečník J, Dahmen RA.AbstractEstablishing the correct etiological diagnosis of autophagic vacuolar myopathies (AVM) is an imperative since the recent availability of the enzyme replacement therapy for the treatment of Pompe disease. Recent recognition of the complex functional pathology of these disorders dramatically changed the view on their pathogenesis and it may lead to identification of new approaches in the therapy. Muscle biopsy is a useful tool for the differential diagnosis of the AVM; however, in some cases it may fail. Through a series of five short case studies we aim at demonstrating the histopathological findings and differential diagnosis of some AVM (Pompe disease, Danon disease and chloroquine myopathy) in muscle biopsy. We also want to address the fact that the way to the correct diagnosis of these disorders can be quite complicated. Awareness of these diseases and the availability of a dry blood spot test for the non-invasive diagnosis of Pompe disease represent a good basis for detecting patients who are still kept under other diagnoses and thus escaping treatment.Keywords: autophagic myopathies - vacuoles - Pompe disease - Danon disease - chloroquine myopathy.
Ceskoslovenská patologie.Cesk Patol.2013 Dec;49(1):39-45.
Establishing the correct etiological diagnosis of autophagic vacuolar myopathies (AVM) is an imperative since the recent availability of the enzyme replacement therapy for the treatment of Pompe disease. Recent recognition of the complex functional pathology of these disorders dramatically changed t
PMID 23432075

Potential of cardiac stem/progenitor cells and induced pluripotent stem cells for cardiac repair in ischaemic heart disease.

Wang WE, Chen X, Houser SR, Zeng C.Source*Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Clinical science (London, England : 1979).Clin Sci (Lond).2013 Oct 1;125(7):319-27. doi: 10.1042/CS20130019.
Stem cell therapy has emerged as a promising strategy for cardiac and vascular repair. The ultimate goal is to rebuild functional myocardium by transplanting exogenous stem cells or by activating native stem cells to induce endogenous repair. CS/PCs (cardiac stem/progenitor cells) are one type of a
PMID 23746375

Murine models of atrophy, cachexia, and sarcopenia in skeletal muscle.

Romanick M, Thompson LV, Brown-Borg HM.SourceDepartment of Physical Therapy, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58203, U S A.
Biochimica et biophysica acta.Biochim Biophys Acta.2013 Sep;1832(9):1410-20. doi: 10.1016/j.bbadis.2013.03.011. Epub 2013 Mar 20.
With the extension of life span over the past several decades, the age-related loss of muscle mass and strength that characterizes sarcopenia is becoming more evident and thus, has a more significant impact on society. To determine ways to intervene and delay, or even arrest the physical frailty and
PMID 23523469

Japanese Journal

呼吸器症状を伴わずに偶発腫瘍として診断された後腹膜リンパ脈管筋腫症(LAM:lymphangiomyomatosis)の1例

田中建,宮崎淳,内田将央 [他],市岡大士,木村友和,及川剛宏,末富崇弘,河合弘二,上杉憲子,那須克宏,西山博之
泌尿器科紀要 = Acta urologica Japonica 59(11), 709-713, 2013-11
… The tumor cells were immunohistochemically positive for α -smooth muscle actin and weakly positive for HMB45, which is consistent with LAM. … LAM is a rare progressive disease that affects mainly the lung, and leads to chronic respiratory failure. …
NAID 120005350256

VGKC複合体抗体関連疾患とアフェレシス

渡邊修
日本アフェレシス学会雑誌 32(3), 185-190, 2013-10-31
… This syndrome is an autoantibody mediated disease of the peripheral nervous system characterized by muscle cramp, neuromyotonia, and hyperhidrosis. …
NAID 110009661552

Thymus histology and concomitant autoimmune diseases in Japanese patients with muscle-specific receptor tyrosine kinase-antibody-positive myasthenia gravis

Nakata Ruka,Motomura Masakatsu,Masuda Tomoko,Shiraishi Hirokazu,Tokuda Masahiro,Fukuda Taku,Ando Takao,Yoshimura Toshiro,Tsujihata Mitsuhiro,Kawakami Atsushi
European Journal of Neurology 20(9), 1272-1276, 2013-09
… Background and purpose: The differences in the characteristics of thymus histology, coexisting autoimmune diseases and related autoantibodies between anti-muscle-specific receptor tyrosine kinase (MuSK)-antibody (Ab)-positive myasthenia gravis (MG) patients, and anti-acetylcholine receptor (AChR)-Ab-positive MG patients are not clearly defined. …
NAID 120005328277