Huang Hung-Ling, Lin Wen-Chih, Tsai Wei-Lun, Weng Chia-Tse, Weng Meng-Yu, Wu Chun-Hsin, Sun Yuan-Ting
Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan.
Department of Physical Medicine and Rehabilitation, Chiali Branch, Chi Mei Medical Centre, Tainan 722, Taiwan.
J Clin Med. 2022 Nov 25;11(23):6972. doi: 10.3390/jcm11236972.
The mutual exclusivity of myositis-specific antibodies (MSAs) has been reported before, but the coexistence of 2 or more MSAs was still found in a few case reports. This study aims to confirm the existence and prevalence of double MSAs in patients with idiopathic inflammatory myopathy (IIM) and to clarify the clinical features of these patients. One hundred fifty-one patients with IIM diagnosed from 1 July 2018 to 31 July 2022, at National Cheng Kung University Hospital, Taiwan, were enrolled and divided into two groups, patients with ≤1 MSA ( = 128, 84.8%) and those with ≥2 MSAs ( = 23, 15.2%) according to the initial serology results. After being re-examined by ANA-IIF assay, 8 out of 23 patients were confirmed to have ≥2 MSAs. The demographic data and clinical features were presented. The prevalence of double-positive MSAs among IIM was 5.3% in this cohort. The coexistence of two MSAs in an IIM patient does exist but is rare. Patients with two MSAs belonging to two distinct IIM subtypes presented clinical features skewed to one subtype instead of "mixed phenotypes". No apparent difference in clinical severity was found between patients with ≥2 MSAs and ≤1 MSA. Longer follow-ups and more studies are required to characterize the patients of IIM with ≥2 MSAs.
肌炎特异性抗体（MSA）的相互排斥性此前已有报道，但在一些病例报告中仍发现有2种或更多种MSA共存的情况。本研究旨在确认特发性炎性肌病（IIM）患者中双重MSA的存在及患病率，并阐明这些患者的临床特征。纳入了2018年7月1日至2022年7月31日在台湾国立成功大学医院诊断的151例IIM患者，并根据初始血清学结果将其分为两组，即MSA≤1种的患者（n = 128，84.8%）和MSA≥2种的患者（n = 23，15.2%）。经ANA-IIF检测重新检查后，23例患者中有8例被确认有≥2种MSA。呈现了人口统计学数据和临床特征。该队列中IIM患者双重阳性MSA的患病率为5.3%。IIM患者中两种MSA共存确实存在，但很罕见。属于两种不同IIM亚型的两种MSA共存的患者表现出偏向一种亚型的临床特征，而非“混合表型”。MSA≥2种的患者与MSA≤1种的患者在临床严重程度上未发现明显差异。需要更长时间的随访和更多研究来描述MSA≥2种的IIM患者的特征。
