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The relative prevalence of dermatomyositis and polymyositis in Europe exhibits a latitudinal gradient
  1. G J D Hengstmana,
  2. W J van Venrooijb,
  3. J Vencovskyc,
  4. H M Moutsopoulosd,
  5. B G M van Engelena
  1. aNeuromuscular Centre Nijmegen, Institute of Neurology, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands, bDepartment of Biochemistry, University of Nijmegen, Nijmegen, the Netherlands, cInstitute of Rheumatology, Prague, Czech Republic, dDepartment of Pathophysiology, School of Medicine, National University of Athens, Athens, Greece
  1. Dr van Engelen

https://doi.org/10.1136/ard.59.2.141

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    The idiopathic inflammatory myopathies (IIM) are a heterogeneous group of systemic diseases that include the more familiar disease entities of dermatomyositis (DM), polymyositis (PM), and inclusion body myositis (IBM).1 The aetiology of IIM is unknown. DM and PM are commonly regarded as autoimmune diseases,1 while the immune response in IBM is thought to be secondary to degenerative changes in skeletal muscle tissue.2 The autoimmunity in DM and PM is most probably a result of the interaction of environmental and host factors.1 ,3 Environmental risk factors are suggested by the fact that several viruses (for example, picorna, influenza, paramyxo) have been associated directly or indirectly with IIM, by unconfirmed reports of coxsackie B virus antibodies in children with DM, and …

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