Misdiagnosis of easy polymyositis

Misdiagnosis of abnormal liver function and hepatitis: Many polymyositis in the early days was misdiagnosed as "severe hepatitis." Because the face of an appeal mainly to fatigue patients, other doctors found no abnormalities, then the patient often to check liver function. Polymyositis and often very high performance for aminotransferase, clinicians often follow such a thinking: "fatigue - increased aminotransferase (abnormal liver function) - Hepatitis" diagnosis. Spectrum, including muscle enzyme aspartate aminotransferase (AST / sGOT), alanine aminotransferase (ALT / sGPT), lactate dehydrogenase (LDH), and so on. One GPT, aspartate aminotransferase and liver enzyme LDH is also, on behalf of liver function, liver damage, these enzymes will be increased. Experienced doctors from the two are often found in transaminase problem. While these two aminotransferase may originate from muscle and liver, but aspartate aminotransferase from more muscles, while GPT more from the liver. Therefore, aspartate aminotransferase significantly higher than GPT, should pay attention to muscle damage, for further investigation, such as creatine phosphokinase. Muscle enzymes increased misdiagnosed as heart disease: Acute myocardial infarction and severe myocarditis often a spectrum of increased muscle. As clinicians to heart disease than the general impression is that some doctors unfamiliar polymyositis, a muscle-spectrum to see increased, taking into account the heart. Therefore polymyositis also often misdiagnosed as heart disease. Identification of the main points of the ECG proximal limbs, muscle strength and characteristics of the change. Misdiagnosis of myasthenia gravis: Myasthenia gravis is a joint due to nerve endings and muscle, nerve agents anomaly caused by the disease, a neurological disease. And polymyositis is immune-mediated inflammation of the muscle lesions, a Feng Shike of the disease. Both performance for myasthenia gravis, there are often misdiagnosed. Of the difference between two points is the eyelids droop with myasthenia gravis, Chen Qi, lighter symptoms, gradually increase the daytime, evening more evident, both proximal and distal limb weakness, and polymyositis no eyelids droop, the proximal MG-based, so even if a serious weakness to the extent bedridden, the handshake is often powerful. Only treatment of polymyositis, forgot to check tumor: 20% to 30% of patients with polymyositis have cancer, some patients with cancer at the same time is myositis onset; some tumor first, and polymyositis in the post; Some in myositis after a few months or years Found that tumor. This part of the polymyositis patients are often not an ideal treatment, and difficult to attain complete remission. But if the cancer cure (such as surgical resection), myositis died and more, tumor recurrence, polymyositis also recurrence. Therefore, any clinical diagnosis of polymyositis, must thoroughly inspect and remove a potential tumor.