Detecting myositis as a cause of unexplained dysphagia: Proposal for a diagnostic algorithm.

Labeit, Bendix; Grond, Thalia; Beule, Achim G; Boehmer, Maik; Thomas, Christian; Muhle, Paul; Claus, Inga; Roderigo, Malte, Rudack, Claudia; Wiendl, Heinz; Dziewas, Rainer; Warnecke, Tobias; Suntrup-Krueger, Sonja

Zusammenfassung

Over a period of 4 years, patients with unexplained dysphagia were offered diagnostic evaluation according to a specific algorithm: The pattern of dysphagia was characterized by instrumental assessment (swallowing endoscopy, videofluoroscopy, high-resolution manometry). Patients with an IIM-compatible dysphagia pattern were subjected to further IIM-focused diagnostic procedures, including whole-body muscle magnetic resonance imaging, electromyography, creatine kinase blood level, IIM antibody panel and, as a final diagnostic step, muscle biopsy. Muscle biopsies were taken from affected muscles. In cases where no other muscles showed abnormalities, the cricopharyngeal muscle was targeted.