Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis.
Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis.
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DOI：
10.1002/art.39466
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Childhood Myositis Heterogeneity Study Group
中科院分区：
文献类型：
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作者：
Habers GE;Huber AM;Mamyrova G;Targoff IN;O'Hanlon TP;Adams S;Pandey JP;Boonacker C;van Brussel M;Miller FW;van Royen-Kerkhof A;Rider LG;Childhood Myositis Heterogeneity Study Group
目的：探讨青少年特发性炎性肌病（JIIM）患者病程的早期相关因素。在大型JIIM注册表（n=365）中进行单变量和多变量多项logistic回归分析，包括人口统计学、早期临床特征、血清肌酶水平、肌炎自身抗体、环境暴露和免疫遗传多态性。与单环相比，与慢性或多环病程相关的多变量包括肌炎特异性自身抗体（多项优势比（M-OR）分别为4.2和2.8），肌炎相关自身抗体（M-OR为4.8和3.5），以及发病6个月内记录的感染（M-OR为2.5和4.7）。与多环相比，诊断时较高的总体临床症状评分与慢性或单环疗程相关。此外，与单环或多环病程相比，严重疾病发作与慢性病程相关（M-OR为2.1和2.6），而与单环病程相比，抗p155/140自身抗体与慢性或多环病程相关（M-OR为3.9和2.3）。与单环病程相比，慢性病程的其他单变量关联包括光敏性、“v征”或“披肩征”皮疹和角质层过度生长（or 2.2-3.2）。与多环病程相比，诊断前一个月的平均紫外线指数和最高紫外线指数与慢性病程相关（OR为1.3和1.5），而居住在西北地区与慢性病程相关的频率较低（OR为0.2）。肌炎自身抗体，特别是抗p155/140抗体，以及许多早期临床特征和环境暴露与JIIM患者的慢性病程有关。这些发现表明，可以确定与JIIM预后较差相关的早期因素。
To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (JIIM). Univariable and multivariable multinomial logistic regression analyses were performed in a large JIIM registry (n=365), including demographics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms. Multivariable associations with chronic or polycyclic courses compared to monocyclic included myositis-specific autoantibodies (multinomial odds ratio (M-OR) 4.2 and 2.8, respectively), myositis-associated autoantibodies (M-OR 4.8 and 3.5), and a documented infection within six months of illness onset (M-OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to polycyclic. Furthermore, a severe illness onset was associated with chronic compared to monocyclic or polycyclic courses (M-OR 2.1 and 2.6), while anti-p155/140 autoantibodies were associated with chronic or polycyclic courses compared to monocyclic (M-OR 3.9 and 2.3). Additional univariable associations of chronic compared to monocyclic course included photosensitivity, “V-sign” or “Shawl-sign” rashes, and cuticular overgrowth (OR 2.2–3.2). The mean and highest ultraviolet index in the month before diagnosis were associated with a chronic compared to polycyclic course in boys (OR 1.3 and 1.5), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2). Myositis autoantibodies, in particular anti-p155/140, and a number of early clinical features and environmental exposures were associated with a chronic course in patients with JIIM. These findings suggest early factors can be identified that are associated with poorer outcomes in JIIM.