suggested diagnostic criteria for inclusion lymphocytes
A. Clinical findings
- Disease duration> 6 months.
- Aldersdebut> 30 years.
- Slow progressive muscle weakness / atrophy; Selective pattern with early affection of quadriceps and finger reflectors, possibly asymmetrical.
- CK values <12 x normal value.
- EMG; Myopathic or mixed pattern with both short and long "MUP" and spontaneous activity.
C. Muscle Biopsy
- Necrosis and regeneration of muscle fibers.
- Mononuclear cell infiltrate in endomysite.
- Mononuclear cell invasion of non-necrotic fibers (specCD8 + T cells).
- Upgrading of MHC Class I.
- Rimmed vacuoles.
- Amyloid in muscle fiber.
- By electron microscopy; Nuclear and / or cytoplasmic inclusions.
- COX-negative fibers.
II. Associated diseases
IBM can be associated with
- Other autoimmune diseases, collagenoses.
- Infections (e.g., HIV, Hepatitis C).
III. Histological criteria for IBM
Definitive IBM requires muscle biopsy with the following findings:
- Invasion of mononuclear cells in non-necrotic fibers.
- Vacuoles in muscle fibers.
- Intracellular amyloid deposits or
- 15-18 nm tubular filament.
- If these biopsy fins are present, neither is laboratory drug Or clinic obligate for diagnosis.