The first signs of IBM also known as Inclusion Body Myositis are frequent tripping and falls, foot drop, hand and finger weakness and difficulty standing or climbing.
Weakness in your quadriceps (thigh muscles) as a result of Inclusion Body Myositis can cause your knees to suddenly buckle or give way.
And foot drop with Inclusion Body Myositis is when you have difficulty in lifting the front part of your foot that causes your toes to drag, which leads to stumbling.
Hand and finger weakness as a result of Inclusion Body Myositis, involves loss of dexterity and grip strength, which results in trouble with fine motor tasks, such as turning a key, opening a jar or buttoning of a shirt.
And difficulty standing or climbing as a result of Inclusion Body Myositis can involve having trouble getting up from a low chair or stepping up onto curbs.
Early symptoms and signs of IBM or Inclusion Body Myositis, mainly involve slowly progressive muscle weakness in your fingers, wrists and thighs.
And people with Inclusion Body Myositis often experience frequent and unexplained trips and falls, which is often called "foot drop", weakened hand grips as well as difficulty rising from a seated position or climbing up stairs.
These early signs of Inclusion Body Myositis can easily be mistaken for the affects of normal aging, which also often results in a huge delay in diagnosis.
The early symptoms of Inclusion Body Myositis often manifest gradually over months or even years and they can also differ from person to person.
Other less common early symptoms of Inclusion Body Myositis or IBM include Dysphagia, which are swallowing difficulties and shoulder and arm weakness, where you have weakness in your arms and shoulder when attempting to reach overhead or comb your hair.
Symptoms are often brushed off initially when you have Inclusion Body Myositis because Inclusion Body Myositis primarily affects adults over age 50 and progresses so slowly.
Myositis is typically diagnosed through elevated levels of muscle enzymes (especially creatine kinase, aldolase, LDH, and AST/ALT) that leak into the bloodstream when muscle fibers break down.
Autoimmune forms of myositis are further identified by positive antinuclear antibodies (ANA) and specific myositis-related autoantibodies.
The main laboratory markers for myositis can be broken down into three key categories:
1. Muscle Enzymes
When muscle tissue is damaged or inflamed, intracellular enzymes leak out and cause elevated blood levels.
Creatine Kinase (CK): The most specific and widely used blood test for muscle damage.
Levels can often reach 10 to 50 times the normal range, especially in acute myopathies.
Aldolase: Often elevated and sometimes used as a marker when CK levels are surprisingly normal.
Lactate Dehydrogenase (LDH): An enzyme found in muscle tissue (as well as the heart and liver) that frequently spikes during muscle breakdown.
AST and ALT (Aspartate Aminotransferase and Alanine Aminotransferase): While primarily thought of as liver enzymes, these are also highly concentrated in muscles. In myositis, they are often elevated in the absence of any liver issues.
2. Autoantibodies (Immune Markers)
Many types of myositis are autoimmune in nature. Doctors typically screen for these using blood tests to determine the specific subtype of the disease.
Antinuclear Antibodies (ANA): A broad screening test for autoimmune diseases. A positive ANA indicates an underlying immune issue but is not specific to myositis.
Myositis-Specific Antibodies (MSA): These pinpoint the exact type of myositis and help predict potential complications (such as lung or heart involvement).
Common examples include:
Anti-Jo-1: The most common myositis-specific antibody, often associated with lung disease (antisynthetase syndrome).
Anti-Mi-2: Frequently seen in dermatomyositis (typically with characteristic skin rashes).
Anti-SRP: Often tied to acute, severe muscle weakness and cardiac issues.
Anti-HMGCR: Seen in immune-mediated necrotizing myopathy (often linked to statin use).
3. General Markers of Inflammation
Myositis causes widespread or systemic inflammation, which can be detected by general blood tests.
C-Reactive Protein (CRP): A protein produced by the liver that spikes in response to inflammation.
Erythrocyte Sedimentation Rate (ESR): A blood test that measures how quickly red blood cells settle to the bottom of a test tube; an accelerated rate usually points to inflammatory activity in the body.