Lupus and Muscle Weakness

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Lupus

and Muscle Weakness

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.

Hugs,

Deanna