title: Diaphragmatic dysfunction in patients with idiopathic inflammatory myopathies.
abstract: Polymyositis, dermatopolymyositis, and inclusion body myositis imply chronic inflammation of skeletal muscles. Pulmonary complications include aspiration pneumonia, interstitial pneumonitis, or respiratory muscle myositis. This study aims at better describing their impact on respiratory muscle. Twenty-three consecutive patients (12 PM, 5 DM, 6 IBM) were studied (static inspiratory and expiratory pressures; diaphragm function in terms of the mouth and transdiaphragmatic pressure responses to bilateral phrenic stimulation). Pulmonary parenchymatous abnormalities were mild (6 cases) or absent. The mouth pressure produced by phrenic stimulation was 6.83+/-3.01 cm H2O, with 18 patients (78%) diagnosed with diaphragm weakness (<10 cm H2O) and lower values in DM (4.35+/-1.48 cm H2O) than in IBM and in PM (P<0.05). Diaphragm weakness is frequent and probably overlooked in inflammatory myopathies. Further studies are needed to delineate the clinical relevance of these results.
authors.affiliation: UPRES EA 2397, Université Pierre et Marie Curie Paris VI, Paris, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Teixeira
authors.forename: Patrick
authors.initials: P
authors.lastname: Cherin
authors.forename: Alexandre
authors.initials: A
authors.lastname: Demoule
authors.forename: Michèle
authors.initials: M
authors.lastname: Levy-Soussan
authors.forename: Christian
authors.initials: C
authors.lastname: Straus
authors.forename: Eric
authors.initials: E
authors.lastname: Verin
authors.forename: Marc
authors.initials: M
authors.lastname: Zelter
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Derenne
authors.forename: Serge
authors.initials: S
authors.lastname: Herson
authors.forename: Thomas
authors.initials: T
authors.lastname: Similowski
mesh_terms: D000368:Aged; D003964:Diaphragm / Q000503:physiopathology*; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications*; D009431:Neural Conduction; D009468:Neuromuscular Diseases / Q000503:physiopathology; D010791:Phrenic Nerve / Q000503:physiopathology; D012119:Respiration; D012129:Respiratory Function Tests / Q000379:methods; D012133:Respiratory Paralysis / Q000209:etiology*; D018709:Statistics, Nonparametric