Section of Rheumatology, Department of Internal Medicine, Jordan University Hospital, Queen Rania St, PO Box 13046, 11942 Amman, Jordan.
Clin Rheumatol. 2010 Dec;29(12):1381-5. doi: 10.1007/s10067-010-1465-8. Epub 2010 Apr 21.
To describe demographic characteristics, clinical features and outcome of Jordanian patients with idiopathic inflammatory myopathies (IIM), a retrospective chart review of all patients diagnosed with IIM at Jordan University Hospital between 1996 and 2009 was carried out. Thirty patients with IIM were identified. Female to male ratio was 1.7:1, with mean age at diagnosis 34.3 ± 9.2 (10-72) years with bimodal presentation at 21 and 49 years and a mean follow-up of 6.5 ± 5.7 years. Eleven patients had polymyositis (PM); 19 patients had dermatomyositis (DM); 1 patient had DM with malignancy; 2 patients had juvenile DM; and 2 patients had DM/PM with other rheumatologic diseases. Raynaud's phenomenon was present in 26% of patients, dysphagia in 40%, fever in 16%, arthralgia/arthritis in 26%, and dyspnea was present in 26% patients. Positive muscle biopsy and EMG were present in 81% and 92% of patients, respectively. Elevated serum creatinine kinase (CK), AST/ALT and LDH were found in 90%, 72%, and 88% of patients at presentation, respectively. Interstitial fibrosis identified on high-resolution computed tomography (HRCT) was found in 7/14 (50%) patients. Restrictive lung disease was present in 16/21 (76%), low diffusion capacity of lung of carbon monoxide (DLCO) in 10/17 (59%) and pulmonary hypertension in only 3/19 (16%) patients tested. Arab Jordanian patients with IIM showed very low prevalence of malignancy, lower mean age than previous reports, and similar other clinical, laboratory and serologic markers, and survival rate to previous reports. Of interest, we found that extra-muscular manifestations were mainly associated with dermatomyositis.
为了描述约旦特发性炎性肌病(IIM)患者的人口统计学特征、临床特征和结局,我们对 1996 年至 2009 年期间在约旦大学医院诊断为 IIM 的所有患者进行了回顾性图表审查。共确定了 30 名 IIM 患者。男女比例为 1.7:1,诊断时的平均年龄为 34.3 ± 9.2(10-72)岁,21 岁和 49 岁呈双峰表现,平均随访 6.5 ± 5.7 年。11 名患者患有多发性肌炎(PM);19 名患者患有皮肌炎(DM);1 名患者患有 DM 合并恶性肿瘤;2 名患者患有幼年型 DM;2 名患者患有 DM/PM 合并其他风湿病。26%的患者存在雷诺现象,40%的患者存在吞咽困难,16%的患者存在发热,26%的患者存在关节痛/关节炎,26%的患者存在呼吸困难。81%和 92%的患者分别存在阳性肌肉活检和肌电图。90%、72%和 88%的患者在就诊时发现血清肌酸激酶(CK)、AST/ALT 和 LDH 升高。14 名患者中的 7 名(50%)在高分辨率计算机断层扫描(HRCT)上发现间质纤维化。21 名患者中有 16 名(76%)存在限制性肺疾病,17 名中有 10 名(59%)存在一氧化碳弥散量(DLCO)降低,19 名中有 3 名(16%)患者存在肺动脉高压。阿拉伯约旦的 IIM 患者的恶性肿瘤患病率非常低,平均年龄低于以往报道,其他临床、实验室和血清学标志物以及生存率与以往报道相似。有趣的是,我们发现肌肉外表现主要与皮肌炎有关。