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Comparison of the 2017 EULAR/ACR Criteria with Clinicoserologic Criteria for the Classification of Idiopathic Inflammatory Myopathies in Korean Patients

Yonsei Medical Journal 2021년 62권 5호 p.424 ~ 430
정상완, 유인설, 김진현, 강성욱, 권미혜, 정청일, 최인아, 장성혜, 강미일, 홍승재, 이연아,
소속 상세정보
정상완 ( Chung Sang-Wan ) - Kyung Hee University Medical Center Department of Internal Medicine
유인설 ( Yoo In-Seol ) - Chungnam National University School of Medicine Department of Internal Medicine
김진현 ( Kim Jin-Hyun ) - Chungnam National University School of Medicine Department of Internal Medicine
강성욱 ( Kang Seong-Wook ) - Chungnam National University School of Medicine Department of Internal Medicine
권미혜 ( Kwon Mi-Hye ) - Konyang University College of Medicine Department of Internal Medicine
정청일 ( Joung Chung-Il ) - Konyang University College of Medicine Department of Internal Medicine
최인아 ( Choi In-Ah ) - Chungbuk National University College of Medicine Department of Internal Medicine
장성혜 ( Chang Sung-Hae ) - Soonchunhyang University College of Medicine Department of Internal Medicine
강미일 ( Kang Mi-Il ) - Dankook University College of Medicine Department of Internal Medicine
홍승재 ( Hong Seung-Jae ) - Kyung Hee University Medical Center Department of Internal Medicine
이연아 ( Lee Yeon-Ah ) - Kyung Hee University Medical Center Department of Internal Medicine

Abstract


Purpose: To investigate correlations between myositis-specific autoantibodies (MSA) or myositis-associated antibodies (MAA) and clinical features, thereby demonstrating the utility of clinicoserologic classification in idiopathic inflammatory myopathies (IIM) patients.

Materials and Methods: We conducted a multicenter study of 108 adult patients (age ≥18 years) who were diagnosed with IIM by Peter and Bohan criteria or 2004 European Neuromuscular Centre (ENMC) criteria. Clinical data were obtained by medical record review. Immunoblot assay with Euroline strip (EUROIMMUN, Germany) was performed using the sera of dermatomyositis (DM, n=56), polymyositis (PM, n=45), amyopathic DM (n=5), DM sine dermatitis (n=1), and immune mediated necrotizing myopathy (n=1) patients. Patients were classified based on two classifications: 2017 EULAR/ACR and novel clinicoserologic classification.

Results: According to 2017 EULAR/ACR criteria, DM and PM were the most and the second most frequent entities. Overlap myositis was the major entity of IIM, and the frequency of PM was significantly lower when applying clinicoserologic classification criteria. Sixty-nine (63.9%) patients had one or more MSA, and 61 (56.5%) patients had one or more MAA. Interstitial lung disease was closely associated with anti-MDA5 and anti-ARS, and DM-specific skin lesions were frequently observed in patients with anti-TIF1γ, anti-SRP, and anti-MDA5.

Conclusion: The clinicoserologic criteria based on MSA/MAA positivity could reflect more precise clinical features of IIM. Establishment of a laboratory system routinely available to screen for MSA/MAA status will be beneficial to provide precise diagnosis and proper management of IIM patients.

키워드

Idiopathic inflammatory myositis; novel classification criteria; overlap myositis; myositis specific autoantibody

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