Rheumatologist, Rheumatology Tasmania, 4 Warneford St, Hobart, TAS, 7000, Australia.
Rheumatology Department, Royal Adelaide Hospital, Port Rd, Adelaide, SA, 5000, Australia.
Rheumatol Int. 2019 Oct;39(10):1777-1781. doi: 10.1007/s00296-019-04411-8. Epub 2019 Aug 5.
We sought to determine the prevalence of additional connective tissue diseases (CTDs) in patients with idiopathic inflammatory myopathies (IIM), and to study the muscle biopsy patterns in various clinico-serologic subsets of myositis. We undertook a retrospective cohort study of 648 patients with a histological diagnosis of IIM. The following was determined from the South Australian Myositis Database: presence of associated CTDs, histological details and presence of myositis-specific (MSA) or myositis-associated (MAA) antibodies. Among patients with IIM, a significantly greater proportion had systemic sclerosis 32/648 (4.9%) than mixed connective tissue disease (12/648, p = 0.003), primary Sjogren's syndrome (12/648, p = 0.003), systemic lupus erythematosus (10/648, p < 0.001) or rheumatoid arthritis (6/648, p = 0.0001). Polymyositis was the most common IIM diagnosis regardless of the presence or absence of CTD. MSA/MAA was more commonly detected in those with systemic sclerosis than those with IIM alone (OR 5.35, p < 0.005). The higher prevalence of SSc (compared with other CTDs) in IIM, together with the more frequent detection of autoantibodies in this group, suggests that these conditions may be linked.
我们旨在确定特发性炎性肌病(IIM)患者中额外结缔组织病(CTD)的患病率,并研究肌炎各种临床血清学亚组的肌肉活检模式。我们对 648 名具有组织学诊断为 IIM 的患者进行了回顾性队列研究。从南澳大利亚肌炎数据库中确定了以下内容:是否存在相关 CTD、组织学细节以及是否存在肌炎特异性(MSA)或肌炎相关(MAA)抗体。在 IIM 患者中,患有系统性硬化症的患者明显多于混合性结缔组织病(32/648,4.9%)(12/648,p=0.003)、原发性干燥综合征(12/648,p=0.003)、系统性红斑狼疮(10/648,p<0.001)或类风湿关节炎(6/648,p=0.0001)。无论是否存在 CTD,多发性肌炎都是最常见的 IIM 诊断。在患有系统性硬化症的患者中,比单独患有 IIM 的患者更常检测到 MSA/MAA(OR 5.35,p<0.005)。与其他 CTD 相比,SSc 在 IIM 中的更高患病率,以及在该组中更频繁地检测到自身抗体,表明这些疾病可能相关。