Lupus and Muscle Weakness

[Guest guest]

Lupus Myositis

Unlike the joints, the muscles can be seriously damaged by SLE. This

damage may result in muscle weakness and loss of strength unless early,

appropriate treatment is given. Inflamed muscles may not only be painful,

but may also be tender to the touch. Muscle weakness is the most common

symptom of lupus myositis.

Characteristically, the muscles of the trunk of the body are affected

(i.e., neck, pelvic girdle and thighs, shoulder girdle and upper arms).

Pain in the small muscles of the hand or weakness of the grip are not symptoms

of SLE myositis. However, nerves as well as muscle fibers can be caught

up in the inflammatory process and, occasionally, weakness of the wrists

and hands or the ankles and feet may occur as a result of nerve damage.

Diagnosis.

The diagnosis of SLE myositis is relatively straightforward. There are

chemical enzymes (e.g., CPK, SGOT, SGPT, aldolase) which are normally concentrated

within muscle fibers and which escape into the blood circulation when muscle

fibers are being damaged by inflammation. Thus, tests for these chemicals

in the blood are abnormal in SLE myositis. These tests can also be used

to determine the severity of muscle involvement: more severe myositis results

in a higher level of these enzymes in the blood. Such tests are therefore

useful in the diagnosis of SLE myositis, and in following the course of

the disease and its response to therapy.

Just as the electrocardiogram (EKG) reflects damage to heart muscle,

the electromyogram (EMG) can be used to determine the character of muscle

damage in lupus myositis. When inflammation is present, the EMG shows a

characteristic pattern of electrical response. A microscopic examination

of a sample of muscle tissue a biopsy) may also be taken from a painful

muscle to confirm the presence of inflammation and to help identify the

severity of the inflammation.

Treatment.

Corticosteroids (Prednisone) are necessarily prescribed for the treatment

of SLE myositis. High doses (50 mg. per day or more of Prednisone or equivalent)

are initially given for prompt suppression and control of the inflammation.

The steroid dose is gradually reduced as the inflammation subsides, as

determined by the patient's symptoms and enzyme levels in the blood. The

vast majority of people with lupus respond promptly and well to corticosteroids.

It is seldom necessary to augment treatment with cytotoxic or immuno-suppressive

medications.

Once the acute, inflammatory phase is past, a well directed exercise

program should be started to help the patient regain normal muscle strength

and function.