Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Pediatr Rheumatol Online J. 2011 Aug 9;9:20. doi: 10.1186/1546-0096-9-20.
Inflammatory myositis is reported in 4-16% of adult systemic lupus erythematosus (SLE) patients. The aim of this study was to determine the prevalence of myositis in a cohort of pediatric SLE patients in the southeastern United States. A retrospective chart review was performed of 55 SLE patients evaluated by Pediatric Rheumatologists in Alabama since January 1, 2008. Patients were defined as having myositis if they satisfied one of the following categories: 1) Proximal muscle weakness on exam with lower extremity muscle edema on MRI; 2) Proximal muscle weakness with elevation in CK, AST, aldolase, or LDH muscle enzymes; or 3) Patient reported weakness or muscle pain and an elevated CK. Inflammatory myositis was present as a feature of SLE in 31% (n = 17) with a 95% confidence interval of 19-45%, statistically different from the reported rates of 4-16% (p < 0.0001). Myositis was positively associated with the presence of anti-ribonucleoprotein antibodies (p = 0.009). Negative associations with myositis were the presence of anti-double stranded DNA antibodies (p = 0.02) and hematologic disorders (p = 0.02). Thus, in the state of Alabama, pediatric SLE myositis is present at a statistically higher rate than previously published values of adult SLE myositis, possibly reflecting geographic (genetic or environmental) and/or age-of-onset related influence(s).
在成人系统性红斑狼疮（SLE）患者中，有 4-16%报告患有炎性肌病。本研究的目的是确定美国东南部儿科 SLE 患者队列中肌炎的患病率。对 2008 年 1 月 1 日以来在阿拉巴马州由儿科风湿病医生评估的 55 例 SLE 患者进行了回顾性图表审查。如果患者满足以下类别之一，则定义为患有肌炎：1）MRI 显示下肢肌肉水肿的体检近端肌肉无力；2）肌酸激酶、AST、醛缩酶或 LDH 肌酶升高伴近端肌肉无力；或 3）患者报告肌无力或肌肉疼痛和肌酸激酶升高。炎性肌病是 SLE 的一个特征，占 31%（n=17），95%置信区间为 19-45%，与报告的 4-16%（p<0.0001）的发生率统计学上不同。肌炎与抗核糖核蛋白抗体的存在呈正相关（p=0.009）。与肌炎呈负相关的是抗双链 DNA 抗体的存在（p=0.02）和血液学疾病（p=0.02）。因此，在阿拉巴马州，儿科 SLE 肌炎的发生率明显高于先前发表的成人 SLE 肌炎值，这可能反映了地理（遗传或环境）和/或发病年龄相关的影响。
