TY - JOUR
T1 - Dysphagia in inflammatory myopathy
T2 - Clinical characteristics, treatment strategies, and outcome in 62 patients
AU - Oh, Terry H.
AU - Brumfield, Kathlyn A.
AU - Hoskin, Tanya L.
AU - Stolp, Kathryn A.
AU - Murray, Joseph A.
AU - Basford, Jeffrey R.
PY - 2007/4
Y1 - 2007/4
N2 - OBJECTIVE: To assess the clinical characteristics, treatment, and outcome of patients with inflammatory myopathy-associated dysphagia. PATIENTS AND METHODS: We retrospectively reviewed the medical records of ail patients with inflammatory myopathy-associated dysphagia seen at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. RESULTS: A total of 783 patients were diagnosed as having inflammatory myopathy during the 5-year study period. Of these, 62 patients (41 women and 21 men; mean age, 68.6 years) had inflammatory myopathy-associated dysphagia: 26 with inclusion body myositis (IBM), 18 with dermatomyositis, 9 with polymyositis, and 9 with overlap syndrome. Dysphagia was a presenting symptom in 13 patients (21%), with the highest incidence in the IBM group. Videofluoroscopic examinations revealed pharyngeal pooling and impaired oropharyngeal and cricopharyngeal function. The benefits of swallowing compensation techniques and exercises were difficult to establish. Interventional procedures were performed in 24 patients (39%) and most frequently (62%) in patients with IBM, with cricopharyngeal myotomy being most beneficial. Patients with IBM had the least symptomatic improvement. Overall, 11 patients died during the median follow-up of 38 months, with respiratory failure due to aspiration pneumonia as the most common cause. Mortality was high in patients who required percutaneous endoscopic gastrostomy (7/11, 64%), and 1-year mortality was highest (31%) in those with dermatomyositis. CONCLUSION: Dysphagia is a serious and at times presenting problem in patients with inflammatory myopathy. It occurs most frequently and appears to be most refractory in patients with IBM. The mortality rate was high in patients who required percutaneous endoscopic gastrostomy, and the 1-year mortality rate was the highest in patients with dermatomyositis.
AB - OBJECTIVE: To assess the clinical characteristics, treatment, and outcome of patients with inflammatory myopathy-associated dysphagia. PATIENTS AND METHODS: We retrospectively reviewed the medical records of ail patients with inflammatory myopathy-associated dysphagia seen at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. RESULTS: A total of 783 patients were diagnosed as having inflammatory myopathy during the 5-year study period. Of these, 62 patients (41 women and 21 men; mean age, 68.6 years) had inflammatory myopathy-associated dysphagia: 26 with inclusion body myositis (IBM), 18 with dermatomyositis, 9 with polymyositis, and 9 with overlap syndrome. Dysphagia was a presenting symptom in 13 patients (21%), with the highest incidence in the IBM group. Videofluoroscopic examinations revealed pharyngeal pooling and impaired oropharyngeal and cricopharyngeal function. The benefits of swallowing compensation techniques and exercises were difficult to establish. Interventional procedures were performed in 24 patients (39%) and most frequently (62%) in patients with IBM, with cricopharyngeal myotomy being most beneficial. Patients with IBM had the least symptomatic improvement. Overall, 11 patients died during the median follow-up of 38 months, with respiratory failure due to aspiration pneumonia as the most common cause. Mortality was high in patients who required percutaneous endoscopic gastrostomy (7/11, 64%), and 1-year mortality was highest (31%) in those with dermatomyositis. CONCLUSION: Dysphagia is a serious and at times presenting problem in patients with inflammatory myopathy. It occurs most frequently and appears to be most refractory in patients with IBM. The mortality rate was high in patients who required percutaneous endoscopic gastrostomy, and the 1-year mortality rate was the highest in patients with dermatomyositis.
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U2 - 10.4065/82.4.441
DO - 10.4065/82.4.441
M3 - Article
C2 - 17418072
AN - SCOPUS:34047204142
SN - 0025-6196
VL - 82
SP - 441
EP - 447
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 4
ER -