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越南皮肌炎患者的临床、亚临床特征与自身抗体谱之间的关联。

The association between clinical, subclinical features and autoantibody profile in Vietnamese dermatomyositis patients.

作者信息

Le My Huyen, Dinh Hoa Thi, Le Thu Thi Hoai, Hoang Phuong Thi, Vu Minh Nguyet, Le Doanh Huu

机构信息

National Hospital of Dermatology & Venereology, Hanoi, Vietnam.

Hanoi Medical University, Hanoi, Vietnam.

出版信息

PLOS Glob Public Health. 2023 Jan 12;3(1):e0000979. doi: 10.1371/journal.pgph.0000979. eCollection 2023.

Abstract

There is still a lack of research in Vietnam on the autoantibody profile of dermatomyositis (DM) and its association with clinical and subclinical characteristics. Therefore, we conducted this study to investigate clinical and subclinical correlations with autoantibodies in DM patients. 72 DM patients at Vietnam National Hospital of Dermatology and Venereology (NHDV) from March 2019 to September 2021 were included in this cross-sectional study. Clinical manifestations and laboratory test results of the patients were obtained at the time of visit. Of these, 63 patients were tested for the presence of autoantibodies using an Immunoblot assay. Our findings show that the average age of patients was 41.7 years. The female-male ratio was 1.7:1. The most common skin and muscle manifestations were myalgia (79.2%), heliotrope rash (62.5%), shawl sign (61.1%), Gottron's sign (59.7%), muscle weakness (59.7%), Gottron's papule (52.8%), periungual telangiectasia (41.7%), V-sign (38.9%), poikiloderma (26.4%), periungual fissures (20.8%), Raynaud's phenomenon (15.3%). Among the 63 patients tested for autoantibodies, myositis-specific antibodies (MSAs) were found in 71.4% of the serum samples, and myositis-associated antibodies (MAAs) in 36.5%. Anti-TIF1γ antibody accounted for the highest percentage (28.6%), followed by anti-Ro52 (22.2%), anti-synthetase (17.5%), anti-Mi-2 and anti-MDA5 (both 14.3%). Anti-synthetase antibodies (ARS-Abs) showed a significant association with arthralgia, fever, and Raynaud's phenomenon, while anti-TIF1γ antibodies showed a strong association with V-sign and poikiloderma (p<0.05). Clinical features in dermatomyositis are heterogeneous. Our study results show some associations between clinical features and autoantibodies in patients with DM. The analysis of DM-related autoantibodies is clinically useful, will be essential for the approaches to diagnosis, and management of DM patients.

摘要

越南仍缺乏关于皮肌炎(DM)自身抗体谱及其与临床和亚临床特征关联的研究。因此,我们开展了这项研究,以调查DM患者自身抗体与临床和亚临床特征的相关性。本横断面研究纳入了2019年3月至2021年9月在越南国家皮肤病与性病医院(NHDV)就诊的72例DM患者。在患者就诊时获取其临床表现和实验室检查结果。其中,63例患者采用免疫印迹法检测自身抗体的存在情况。我们的研究结果显示,患者的平均年龄为41.7岁。男女比例为1.7:1。最常见的皮肤和肌肉表现为肌痛(79.2%)、向阳疹(62.5%)、披肩征(61.1%)、Gottron征(59.7%)、肌无力(59.7%)、Gottron丘疹(52.8%)、甲周毛细血管扩张(41.7%)、V征(38.9%)、皮肤异色症(26.4%)、甲周裂隙(20.8%)、雷诺现象(15.3%)。在63例检测自身抗体的患者中,71.4%的血清样本中发现了肌炎特异性抗体(MSAs),36.5%的血清样本中发现了肌炎相关抗体(MAAs)。抗TIF1γ抗体占比最高(28.6%),其次是抗Ro52(22.2%)、抗合成酶抗体(17.5%)、抗Mi-2和抗MDA5(均为14.3%)。抗合成酶抗体(ARS-Abs)与关节痛、发热和雷诺现象显著相关,而抗TIF1γ抗体与V征和皮肤异色症密切相关(p<0.05)。皮肌炎的临床特征具有异质性。我们的研究结果显示了DM患者临床特征与自身抗体之间的一些关联。对DM相关自身抗体的分析在临床上有用,对DM患者的诊断和管理方法至关重要。

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