Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis A Multicenter Cross-sectional Study
Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis A Multicenter Cross-sectional Study
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DOI：
10.1001/archdermatol.2011.52
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发表时间：
2011-04-01
影响因子：
--
通讯作者：
Fujimoto, Manabu
中科院分区：
文献类型：
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作者：
Hamaguchi, Yasuhito;Kuwana, Masataka;Fujimoto, Manabu
目的：阐明日本成年皮肌炎（DM）患者临床和预后特征与皮肌炎（DM）特异性自身抗体（Abs）的关系。设计：回顾性研究。单位：金泽大学医学研究生院皮肤科及合作医疗中心。患者：2003年至2008年间，共有376名连续来我院或合作医疗中心就诊的日本成年糖尿病患者。主要结局指标：患有DM和DM特异性抗体的日本成年患者的临床和实验室特征，包括针对Mi-2、155/140和CADM-140的抗体。结果：DM患者中检测到抗mi -2、抗155/140和抗cadm -140分别为9例（2%）、25例（7%）和43例（11%）。34例多发性肌炎患者、326例系统性硬化症患者和97例系统性红斑狼疮患者均未检测到这些dm特异性抗体。抗mi -2与无间质性肺疾病或恶性肿瘤的典型糖尿病相关，而抗155/140与恶性肿瘤相关。抗cadm -140的患者经常有临床淀粉样病变DM和快速进展的间质性肺疾病。与抗155/140或抗cadm -140患者相比，抗mi -2患者的累积生存率更有利（两组比较P < 0.01）。几乎所有抗cadm -140患者的死亡都发生在诊断后1年内。结论：皮肌炎特异性抗体定义了临床不同的亚群，可用于预测糖尿病患者的临床预后。Arch Dermatol. 2011；147 (4): 391 - 398
Objective: To clarify the association of clinical and prognostic features with dermatomyositis (DM)-specific autoantibodies (Abs) in adult Japanese patients with DM.Design: Retrospective study.Setting: Kanazawa University Graduate School of Medical Science Department of Dermatology and collaborating medical centers.Patients: A total of 376 consecutive adult Japanese patients with DM who visited our hospital or collaborating medical centers between 2003 and 2008.Main Outcome Measures: Clinical and laboratory characteristics of adult Japanese patients with DM and DM-specific Abs that include Abs against Mi-2, 155/140, and CADM-140.Results: In patients with DM, anti-Mi-2, anti-155/140, and anti-CADM-140 were detected in 9 (2%), 25 (7%), and 43 (11%), respectively. These DM-specific Abs were mutually exclusive and were detected in none of 34 patients with polymyositis, 326 with systemic sclerosis, and 97 with systemic lupus erythematosus. Anti-Mi-2 was associated with classical DM without interstitial lung disease or malignancy, whereas anti-155/140 was associated with malignancy. Patients with anti-CADM-140 frequently had clinically amyopathic DM and rapidly progressive interstitial lung disease. Cumulative survival rates were more favorable in patients with anti-Mi-2 compared with those with anti-155/140 or anti-CADM-140 (P < .01 for both comparisons). Nearly all deaths occurred within 1 year after diagnosis in patients with anti-CADM-140.Conclusion: Dermatomyositis-specific Abs define clinically distinct subsets and are useful for predicting clinical outcomes in patients with DM. Arch Dermatol. 2011;147(4):391-398