Serum Muscle Enzymes, Muscle Pathology and Clinical
Muscle Weakness: Correlation in Thai Patients with
Polymyositis/Dermatomyositis
WORA WIT LOUTHRENOO, M.D.*, NUANANONG WEERAYUTWATTANA, M.D.*,
NIRUSH LERTPRASERTSUKE, M.D.**, WARAPORN SUKITAWUT, B.Sc.*
Affiliation : *Division of Rheumatology, Department of Medicine,
**Department of Pathology, Faculty ofMedicine, Chiang Mai University, Chiang Mai 50200, Thailand.
AbstractThe clinical correlation between serum muscle enzymes, muscle pathology and muscle
weakness was studied in 100 Thai patients (22 males and 78 females) with polymyositis (PM) and
dermatomyositis (DM). Their mean ± SD age and duration of disease were 45.0 ± 13.9 years and
6.3 ± 13.4 months, respectively. There was idiopathic PM in 37 cases, idiopathic DM in 13, PM/DM
associated with malignancy in 5 and PM associated with connective tissue disease in 45. Serum muscle
enzymes including ~reatine phosphokinase, lactate dehydrogenase and aspartate aminotransferase
were elevated in 87 per cent, 92 per cent, and 82 per cent of cases, respectively. Abnormal electromyo
graphic findings that were compatible with inflammatory myopathy were found in 76 per cent of
cases. Seventy-seven per cent had an abnormal muscle biopsy that was consistent with polymyo
sitis. There was a significant correlation between serum muscle enzymes and muscle pathology
(p < 0.01). The degree of muscle weakness correlated better with the degree of muscle destruction
(p = 0.01) than the degree of muscle inflammation (p = 0.03). The erythrocyte sedimentation rate
showed no correlation with serum muscle enzymes, muscle pathology or muscle weakness.
Keywords : Polymyositis, Dermatomyositis, Serum Muscle Enzymes, Pathology, Clinical Correlation
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