Dr. M.J. Bazos, Patient Handout
About Your Diagnosis
Myositis is a condition that causes inflammation in muscles. Two types of myositis are “polymyositis” and “dermatomyositis.” They are uncommon conditions that cause muscle weakness in children and adults. Although muscle inflammation is the most common feature of these types of myositis, other organs in the body can be affected such as the skin, lungs, esophagus (food pipe), and joints. No one knows what causes these types of myositis, but it is not an infectious illness (like colds); therefore you cannot “catch” it from another individuals. Myositis is diagnosed by a medical history, physical examination, and blood tests that detect muscle inflammation. In individuals who appear to have myositis, further studies of the nerve and muscle, as well as a muscle biopsy specimen, are used to confirm the diagnosis. Treatment of myositis usually improves the symptoms, but most individuals need to stay on therapy for several years.

Living With Your Diagnosis
Myositis causes weakness, especially in muscles around the shoulder and hip. Individuals therefore have difficulty carrying heavy objects, combing their hair, reaching overhead, getting out of bed or chairs, walking up stairs, and standing for long periods. Some individuals have muscle pain. Fatigue, fever, and poor appetite are common. Arthritis causing pain, swelling, and stiffness in joints can make day-to-day activities difficult. Occasionally, individuals with myositis have an associated lung condition that causes a cough or difficulty breathing. Because the esophagus is made of muscle, some individuals with myositis have difficulty swallowing or have problems with heartburn. Dermatomyositis differs from polymyositis by its typical skin rash, which appears on the chest, shoulders, face, and hands. Many of the symptoms of myositis improve with treatment.

Myositis is most commonly treated with corticosteroids (cortisone-like medicines such as prednisone). Potential side effects of corticosteroids are
increased appetite, weight gain, difficulty sleeping, easy bruising, and stomach upset. Longer term use of corticosteroids can lower your resistance to infection, as well as cause stomach ulcers, muscle weakness, and bone thinning (osteoporosis). Corticosteroids should always be taken with food to prevent stomach upset. In addition, patients should receive adequate amounts of calcium and vitamin D to help prevent osteoporosis. Despite corticosteroid therapy, some individuals continue to have symptoms and require more potent medications such as methotrexate or azathioprine (Imuran). Methotrexate can cause poor appetite, nausea, headaches, mouth sores, and diarrhea. Imuran can cause nausea, vomiting, and diarrhea. Routine blood cell counts and liver function tests are necessary to monitor for abnormalities with both methotrexate and azathioprine. Treatment may continue for several years. All
individuals with myositis should rest their muscles during the early part of the treatment. After the muscle inflammation is improved, special exercises to strengthen muscles should be started.

The DOs
• Rest your muscles until the muscle inflammation improves.
• Take your medicines as prescribed.
• Ask your doctor which over-the-counter medications you may take with your prescription medications.
• Eat a well balanced diet low in carbohydrates and fat to prevent excessive weight gain.

The DON’Ts
• Don't wait to see if side effects from medications will go away.
• Don't begin a rigorous exercise program without your doctor’s advice.
• Don't stop taking the corticosteroid medicine unless your physician instructs you to do so.
• Don't forget to inform your doctor and dentist that you are taking a corticosteroid (prednisone).
• Don't overeat, because corticosteroids may increase your appetite.

When to Call Your Doctor
• You experience any medication side effects.
• The treatment is not decreasing your symptoms
in a reasonable amount of time.
• You begin to notice the return of muscle weakness.