Vol. 13. Núm. 32.
Páginas 1799-1808 (Mayo 2021)

Actualización
Miopatías inflamatorias idiopáticas

Idiopathic inflammatory myopathies

A. Movasat HajkhanA. Abassi PérezC. Bohórquez HerasA. Pérez Gómez
Doi : https://10.1016/j.med.2021.04.010
Opciones
Resumen

Las miopatías inflamatorias idiopáticas (MII) son un grupo heterogéneo de enfermedades inmunomediadas, caracterizadas por inflamación del músculo esquelético. Existen ocho grupos definidos clínica e histológicamente, los cuales son: polimiositis (PM), dermatomiositis (DM) del adulto, DM juvenil, DM amiopática, miositis con cuerpos de inclusión (MCI), miopatía necrotizante inmunomediada (MNI), miopatías asociadas a neoplasias y miopatías asociadas a otras enfermedades reumáticas autoinmunes sistémicas en el contexto de síndromes de solapamiento. Además de debilidad muscular, pueden presentar otras manifestaciones extramusculares como manifestaciones cutáneas, articulares, pulmonares, digestivas y cardíacas. Hasta un 60% de los pacientes con MII presentan autoanticuerpos que se pueden dividir en dos grandes grupos: los anticuerpos específicos de miositis y los anticuerpos asociados a miositis que pueden estar presentes en las formas de superposición con otras enfermedades sistémicas. Para su diagnóstico es imprescindible la biopsia muscular, ya que el estudio anatomopatológico define el tipo de miositis. El tratamiento consiste en dosis altas de glucocorticoides que, en la mayoría de las ocasiones, precisa la asociación de un inmunosupresor.

Palabras clave
Miopatías inflamatorias idiopáticas
Autoanticuerpos
Biopsia muscular
Glucocorticoides
Inmunosupresores
Abstract

Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of immune-mediated disorders, characterised by inflammation of the skeletal muscle. The 8 groups defined histologically and clinically are as follows: polymyositis (PM), adult dermatomyositis (DM), juvenile DM, amyopathic DM, inclusion-body myositis (IBM), immune-mediated necrotising myopathy (IMNM), myopathies associated with neoplasia and myopathies associated with other systemic autoimmune rheumatic conditions in the context of overlap syndromes. In addition to muscle weakness, there may be other extramuscular manifestations such as cutaneous, joint, lung, digestive and cardiac conditions. Up to 60% of the patients with IIM have antibodies that can be divided into 2 large groups: myositis-specific antibodies and myositis-associated antibodies that can be present overlapping with other systemic diseases. Muscle biopsy is essential for their diagnosis, given that the histopathological study defines the type of myositis. Treatment consists of high doses of glucocorticoids that, most of the time, requires immunosuppressive therapy as well.

Keywords
Idiopathic inflammatory myopathies
Autoantibodies
Muscle biopsy
Glucocorticoids
Immunosuppressants

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