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与恶性肿瘤相关的抗TIF-1γ抗体阳性皮肌炎的临床特征

Clinical Characteristics of Anti-TIF-1γ Antibody-Positive Dermatomyositis Associated with Malignancy.

作者信息

Harada Yumi, Tominaga Masaki, Iitoh Eriko, Kaieda Shinjiro, Koga Takuma, Fujimoto Kiminori, Chikasue Tomonori, Obara Hitoshi, Kakuma Tatsuyuki, Ida Hiroaki, Kawayama Tomotaka, Hoshino Tomoaki

机构信息

Division of Respirology, Department of Medicine, Neurology and Rheumatology, Kurume University School of Medicine, Kurume 830-0011, Japan.

Department of Radiology, Center for Diagnostic Imaging, Kurume University School of Medicine, Kurume 830-0011, Japan.

出版信息

J Clin Med. 2022 Mar 30;11(7):1925. doi: 10.3390/jcm11071925.

Abstract

We retrospectively analyzed the clinical and laboratory data of patients diagnosed with anti-transcriptional intermediary factor 1 (TIF-1γ) antibody-positive polymyositis (PM)/dermatomyositis (DM) to clarify the characteristics of this disease. We identified 14 patients with TIF-1γ antibody-positive DM (TIF-1γ DM), 47 with anti-aminoacyl-tRNA synthetase antibody (ARS)-positive PM/DM, and 24 with anti-melanoma differentiation-associated gene 5 antibody (MDA-5)-positive PM/DM treated at the Kurume University Hospital between 2002 and 2020. Patients with TIF-1γ DM were significantly older than the other two groups. Nine patients with TIF-1γ DM were female, thirteen patients had DM, and one had clinically amyopathic DM. Primary malignant lesions were lung (3), uterus (2), colon (2), breast (2), ovary (1), lymphoma (1), and unknown (2). Cutaneous manifestation and dysphagia were the most common symptoms in TIF-1γ DM. Erythema (9/14), the V-neck sign (8/14), heliotrope (9/14), and nailfold telangiectasia (14/14) were significantly more common in TIF-1γ DM. Furthermore, no patients with TIF-1γ DM had interstitial lung abnormality on high-resolution CT. In patients with TIF-1γ DM, the frequency of dysphagia and unusual erythema, particularly that which spreads from the trunk, and nailfold telangiectasia, were characteristic findings. In most patients with TIF-1γ DM, it is necessary to administer other immunosuppressive drugs along with glucocorticoids.

摘要

我们回顾性分析了诊断为抗转录中介因子1(TIF-1γ)抗体阳性的多发性肌炎(PM)/皮肌炎(DM)患者的临床和实验室数据,以阐明该疾病的特征。我们确定了2002年至2020年期间在久留米大学医院接受治疗的14例TIF-1γ抗体阳性DM(TIF-1γ DM)患者、47例抗氨酰-tRNA合成酶抗体(ARS)阳性的PM/DM患者和24例抗黑色素瘤分化相关基因5抗体(MDA-5)阳性的PM/DM患者。TIF-1γ DM患者明显比其他两组年龄大。14例TIF-1γ DM患者中9例为女性,13例患有DM,1例为临床无肌病性DM。原发性恶性病变为肺癌(3例)、子宫癌(2例)、结肠癌(2例)、乳腺癌(2例)、卵巢癌(1例)、淋巴瘤(1例)和不明(2例)。皮肤表现和吞咽困难是TIF-1γ DM最常见的症状。红斑(9/14)、V字领征(8/14)、向阳疹(9/14)和甲襞毛细血管扩张(14/14)在TIF-1γ DM中明显更常见。此外,TIF-1γ DM患者在高分辨率CT上均无间质性肺异常。在TIF-1γ DM患者中,吞咽困难和异常红斑,尤其是从躯干蔓延的红斑以及甲襞毛细血管扩张的发生率是其特征性表现。在大多数TIF-1γ DM患者中,除糖皮质激素外还需要使用其他免疫抑制药物。

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