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Epidemic of acute inflammatory myopathy in Karnataka, south India: 30 cases
D Nagaraja1, A B Taly, T G Suresh
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Abstract:
Thirty patients of acute inflammatory myopathy were seen over a short period of 11 months (February to December 1986) at NIMHANS, Bangalore, South India. The characteristic features were: short febrile illness followed a few days later by myalgia, edema of extremities, severe motor weakness and involvement of multiple other systems. Their mean age was 32.3 years and M:F ratio was 4:1. CK levels were increased in all. EMG done in 23 patients showed spontaneous activity in 13 and myopathic pattern in all. Nerve conduction studies revealed abnormalities in 12 cases. Muscle biopsy done in 21 patients showed varying degree of myophagocytosis and inflammatory infiltrates. All patients received steroids for only 6-8 weeks. Twenty-two patients recovered, one developed residual disability and 7 patients died during the acute phase. None of the survivors has developed relapse so far. Such cases with monophasic illness in clusters have not been reported earlier.
Insights
This study describes a cluster of acute inflammatory myopathy cases in South India, characterized by fever, muscle pain, weakness, and multi-system involvement. Most patients recovered with short-term steroid treatment, with no relapses observed.
Area of Science:
- Neurology
- Rheumatology
- Infectious Diseases
Background:
- Acute inflammatory myopathy is a rare condition.
- A cluster of cases was observed over an 11-month period in South India.
- The characteristic clinical presentation and diagnostic findings were documented.
Purpose of the Study:
- To describe the clinical features, diagnostic findings, and outcomes of a cluster of acute inflammatory myopathy cases.
- To report on the efficacy of short-term steroid treatment in this patient group.
- To highlight the unusual occurrence of these cases in clusters.
Main Methods:
- Retrospective review of 30 patients diagnosed with acute inflammatory myopathy.
- Analysis of clinical data, including symptoms, age, sex, and system involvement.
- Review of laboratory investigations (CK levels), electrophysiological studies (EMG, nerve conduction), and muscle biopsy findings.
- Assessment of treatment response and patient outcomes.
Main Results:
- The study identified 30 patients with acute inflammatory myopathy, with a mean age of 32.3 years and a M:F ratio of 4:1.
- Characteristic features included febrile illness, myalgia, edema, severe motor weakness, and multi-system involvement.
- Elevated CK levels, myopathic EMG patterns, and inflammatory infiltrates/myophagocytosis on muscle biopsy were common findings.
- Twenty-two patients recovered after 6-8 weeks of steroid treatment, 7 died, and 1 had residual disability.
- No relapses were reported in the survivors.
Conclusions:
- Acute inflammatory myopathy can present with a distinct clinical syndrome and may occur in clusters.
- Short-term corticosteroid therapy appears effective in managing this condition.
- The monophasic nature and cluster presentation of these cases are noteworthy and warrant further investigation.