Inclusion body myositis, also called IBM, is a degenerative muscle disease that could cause problems with swallowing. It is the most common muscle disease in people older than age 50.
Inclusion body myositis (IBM) is an inflammatory and degenerative muscle disease that causes painless weakening of muscle.
IBM gets worse slowly and is sometimes misdiagnosed as treatment-resistant polymyositis, another inflammatory muscle disease that causes muscle weakness. IBM also may be misdiagnosed as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease).
Symptoms of the disease usually begin after the age of 50, although the disease can occur earlier. IBM occurs more frequently in men than in women and is the most common muscle disease in people aged 50 and older.
The cause of IBM is unknown. Because of the inflammation associated with IBM, some doctors think the disease is a form of autoimmune disorder. In this kind of disorder, the body’s immune system goes awry and attacks its own tissues – in this case, the muscles. Some experts have linked IBM to infection by a virus that has yet to be identified. Other researchers believe that the primary problem in IBM is an age-related inability of the muscle to deal with destructive chemicals.
In IBM, the onset of muscle weakness usually is gradual, occurring over months or years. Falling and tripping usually are the first noticeable symptoms. For some people, IBM begins with weakness in the hands. People with IBM may have:
Doctors use a muscle biopsy to diagnose IBM. After giving an anesthetic, a doctor takes a sample of tissue from one of the affected muscles to be looked at in a laboratory.
When viewed under the microscope, the muscle cells of persons with IBM contain vacuoles (rounded empty spaces). Within the vacuoles, there are usually abnormal clumps of several proteins including one called amyloid. The protein clumps, or inclusion bodies, give IBM its name. This is the hallmark of IBM.
There is no effective course of treatment for IBM. The disease is not responsive to corticosteroids and immunosuppressive drugs – two drugs that often treat inflammatory or autoimmune conditions. Some evidence suggests that intravenous immunoglobulin may help slightly in a small number of cases, but the benefit does not last long.
Physical therapy may be helpful in maintaining mobility and helping to keep joints mobile. Other therapy, including treatments for the swallowing problems, is symptomatic and supportive.
Last reviewed by a Cleveland Clinic medical professional on 04/02/2019.
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