Abstract
SUMMARYIn inflammatory myopathies muscle pain is caused by irritation of the nociceptors. The phenomenon is mediated by substances such as histamine or bradykinin produced by histiocytes and lymphocytes. Furthermore, neuropeptides like substance P or calcitonin-gene related peptide may be involved in this process. The earliest stage of an inflammatory myopathy is interstitial myositis. In acute forms, muscle pain is very prominent. In focal nodular myositis, prominent pain and slight muscle weakness is followed by muscle atrophy. Dermatomyositis is caused by a vasculitis of small blood vessels, associated with deposits of C5b9-complement and tubulovesicular inclusions. Muscle fiber damage is pronounced in the perifascicular region. Muscle pain is common in acute cases. Idiopathic polymyositis produces the pattern of diffuse polymyositis with infiltration of cytotoxic CD8-positive lymphocytes that invade non-necrotic muscle fibers. Muscle pain is less prominent, and may be absent in chronic forms. A specia...
Published Version
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