Document Detail


Juvenile polymyositis or paediatric muscular dystrophy: a detailed re-analysis of 13 cases.
MedLine Citation:
PMID:  19817896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: There has been much debate about the existence of juvenile polymyositis (JPM) as an entity distinct from muscular dystrophy (MD). The aim of this study was to retrospectively analyse muscle biopsies and clinical features of 13 Australian children given an initial diagnosis of JPM, to determine their clinicopathological, immunohistochemical and molecular characteristics. METHODS AND RESULTS: The muscle biopsies on 13 cases were reviewed using detailed morphological and immunoperoxidase studies, with additional protein and molecular analyses, in conjunction with clinical review. Only one case had a true connective tissue disease inflammatory myopathy. Twelve (92.3%) cases with an initial diagnosis of JPM were found on clinical, pathological and molecular review to be MD. CONCLUSIONS: Inflammatory changes in apparently sporadic juvenile myopathies should prompt consideration of an early presentation of MD. Detailed analysis of muscle histopathology, specifically the detection of subsarcolemmal blebbing, isolated fibre degeneration occurring independent of inflammatory infiltrates, patchy clustered major histocompatibility complex-I expression and a CD68+/CD3+ perimysial infiltrate, assists in the diagnosis of early MD. Specific protein and gene analysis adds support to the pathological diagnosis of dystrophy. This series adds weight to suggestions that JPM may not represent a discrete clinical or pathological entity.
Authors:
Colleen E D'Arcy; Monique M Ryan; Catriona A McLean
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Histopathology     Volume:  55     ISSN:  1365-2559     ISO Abbreviation:  Histopathology     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704136     Medline TA:  Histopathology     Country:  England    
Other Details:
Languages:  eng     Pagination:  452-62     Citation Subset:  IM    
Affiliation:
Department of Anatomical Pathology, The Alfred Hospital, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antigens, CD / metabolism
Antigens, CD3 / metabolism
Antigens, CD4 / metabolism
Antigens, CD8 / metabolism
Antigens, Differentiation, Myelomonocytic / metabolism
Australia
Biopsy
Child
Child, Preschool
Cohort Studies
Diagnosis, Differential
Female
Humans
Infant
Major Histocompatibility Complex / physiology
Male
Muscle, Skeletal / immunology,  pathology
Muscular Dystrophies / diagnosis*,  immunology,  pathology*
Polymyositis / diagnosis*,  immunology,  pathology*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, CD3; 0/Antigens, CD4; 0/Antigens, CD8; 0/Antigens, Differentiation, Myelomonocytic; 0/CD68 antigen, human

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