Labordiagnostik bei idiopathischen entzündlichen Muskelerkrankungen

Zusammenfassung

In der Diagnostik der entzündlichen Muskelerkrankungen dient die Messung humoraler Laborparameter zum einen der Erfassung der Muskelschädigung durch Quantifizierung muskeltypischer Enzyme, zum anderen der Charakterisierung myositistypischer Autoantikörper. Letztere sind typischerweise gegen ubiquitäre, nicht-organspezifische intrazelluläre Antigene gerichtet, schließen einander in individuellen Patienten wechselseitig aus und helfen bei der Einteilung der Myositis-Patienten in klinisch relativ homogene Subsets dieser Erkrankungen. Der Katalog der Myositis-Autoantikörper hat sich in den letzten Jahren stark ausgeweitet, betrifft jetzt auch die mit Malignomen assoziierten Myositiden, neu abgegrenzte Entitäten wie die nekrotisierende autoimmune Myositis und möglicherweise auch die Einschlusskörper-Myositis. Was die sehr selektive und spezifische Autoimmunantwort auslöst, bleibt weiterhin bislang rätselhaft.

Abstract

In the diagnostic work-up of inflammatory myopathies, the assessment of humoral laboratory parameters on the one hand serves to evaluate muscle injuries by quantification of muscle-derived enzymes, and, on the other hand is used to characterise autoantibodies typical of myositis. The latter typically are directed against ubiquitous, non-organ-specific intracellular antigens; they exclude each other in individual patients and help to divide myositis patients into relatively homogeneous clinical subsets of these diseases. The catalogue of myositis autoantibodies has expanded considerably in recent years and now also concerns cancer-associated myositis, newly defined entities such as necrotising autoimmune myositis, and possibly also inclusion body myositis. The triggers of this very selective and specific immune response remain elusive.

Schlüsselwörter

Labordiagnostik - Myositis - Autoantikörper

Key words

laboratory diagnostics - myositis - autoantibodies

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