Describing in ammatory muscle disease in Kenya: A single tertiary centre experience in Kenya

Abstract

Background: Infl ammatory muscle diseases are a rare group of connective tissue diseases. There is a paucity of documented literature on indigenous Africans in sub-Saharan Africa. We present herein the clinical patterns
of infl ammatory muscle diseases encountered at a rheumatology clinic, Nairobi, Kenya.

Objective: To describe the clinical spectrum of infl ammatory myopathies at a tertiary rheumatology clinic in Nairobi. These included clinical,  haematological and immunological characteristics of patients with Inflammatory myopathies.

Methods: Medical records of 10,998 patients presenting to the Nairobi Arthritis Clinic for various rheumatological conditions were reviewed. The records of 46 patients with muscle weakness with or without skin rash were selected and reviewed between January 2012 and December 2017 were retrospectively reviewed and reclassifi ed as polymyositis (PM) and dermatomyositis (DM) based on the Bohan and Peter diagnostic criteria.

Results: Forty-six patients (F=36, M=9) were diagnosed with polymyositis and dermatomyositis. Twenty-fi ve had possible dermatomyositis, eighteen had possible polymyositis with another three who had an overlap of polymyositis with other diseases. There were 3 patients with juvenile dermatomyositis. Majority of the patients were referred of which 14 had an alternative diagnosis to myositis. The mean age for PM was 36.36 years and for DM 41.13 years. The creatinine kinase mean was 2845.4 (697-7063)u/l. Serology for ANA tested positive in 8 patients (PM=4, DM=4). The most common symptoms of DM patients included Gottron papules (12), heliotropes rash (15) and shawl sign (5). Myositis antibody screening was not performed in any of the patients.

Conclusion: Infl ammatory myopathies are still rare in Kenya. The clinical spectrum is largely similar to what is known in written literature. From  referral notes and diagnosis of the primary physician, there is a paucity of information about these diseases. None of the patients had myositis  antibody panel due to either unavailability or high cost of doing the tests. More effort should be on increasing awareness of diagnosis and management of these diseases.

Key words: Inflammatory muscle disease, Polymyositis, Dermatomyositis, Nairobi, Kenya