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High risk of cancer in myositis: Expert


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Kochi: Auto-immune disease dermatomyositis patients face a three-fold risk of cancer, while patients with polymyositis face a 40 per cent risk, says expert.

Visiting Professor at the Thrissur based Kerala University of Health Sciences School of Public Health Dr Naresh Purohit on Friday said that medics have known since 1916 that patients with myositis are at a high risk of cancer.

Recent research studies have quantified the risk, finding that dermatomyositis patients face a threefold risk of cancer, while patients with polymyositis face a 40 percent increase in risk, Purohit said while attending a webinar on “Myopathies Post- Covid” organised by the Palakkad based Karuna Medical College.

The epidemiologist told UNI that “what is intriguing is that cancer and myositis often appear around the same time.

“The cancer is usually diagnosed within a year of the muscle disease; while both may go into remission after treatment, the recurrence of one often augurs the recurrence of the other.”

Purohit said myositis is an autoimmune condition in which the immune system itself attacks the muscles of the body.

The prevalence of this condition is between 4-22 cases per one lakh population, according to the Indian Journal of Rheumatology.

“There are different types of Myositis — Polymyositis and Dermatomyositis are the most common ones,” he added.

He averred that the common age group to experience myositis is 40-50 years. A person affected with this condition may not be able to walk due to the pain in the muscles.

He stated that general myositis affects the skeletal muscles, the ones which move arms and legs. Smooth muscles, the ones which are present in the intestine or lungs are not generally affected but can get involved in special cases.

Myositis can also affect cardiac muscles that may lead to a very drastic and dreaded complication causing a life threatening issue.

“Since the muscles which act around shoulders and hip region might be affected, the person may not be able to walk or climb the stairs or reach an object above their head or lift an object,” he added.

According to Purohit, a number of research studies suggest myositis to be a genetic disease are increasing.

“Data show that having at least one first-degree relative with myositis is strongly associated with the risk of it and that several human leukocyte antigen (HLA) regions are associated with it,” he said.

Experts in the webinar said myositis is a treatable disease and can be cured with proper medical attention. “Early diagnosis is the key and that is possible if one consults a physician or rheumatologist early as soon as symptoms appear,” they added.

Experts pointed a patient suffering from this disease will have to be on medications for a long time to prevent this from relapsing. Steroids, oral or intravenous and immunosuppression therapy with drugs like methotrexate and azathioprine can help treat this illness.

“Sometimes the patient may require high doses of intravenous steroids to halt the progression of illness faster. In resistant cases medics use plasma exchange on dialysis machines, intravenous immunoglobulin and rituximab,” they explained

Experts pointed that in some cases, the immune cells bite away the muscles so much that the muscle breaks down. Those waste products of the muscle breakdown and get stuck in the kidneys which can lead to certain complications like the urine becoming dark brown in colour.

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