Schumacher H R, Schimmer B, Gordon G V, Bookspan M A, Brogadir S, Dorwart B B
Am J Med. 1979 Aug;67(2):287-92. doi: 10.1016/0002-9343(79)90404-2.
Nine patients with polymyositis or dermatomyositis associated with arthritis without antinuclear antibodies have been studied. In eight patients a mildly inflammatory nonerosive arthritis occurred coincident with early manifestations or before the appearance of symptomatic muscle disease. Hands, wrists and knees were prominently involved. This arthritis responded to corticosteroids given for the myositis. One patient had erosive arthritis and periarticular calcifications associated with acute inflammation that seemed to diminish with colchicine therapy. Synovial biopsy specimens showed surface fibrin deposition, focal loss of lining cells and mild inflammation--findings similar to those in scleroderma. By electron microscopy tubuloreticular structures were found in vascular endothelium in synovium, as in other tissues in polymyositis. All patients surprisingly had pulmonary manifestations suggesting the possibility that the condition in this group of patients may represent a distinctive subset of polymyositis.
对9例无抗核抗体的多肌炎或皮肌炎合并关节炎患者进行了研究。8例患者出现轻度炎症性非侵蚀性关节炎，与早期表现同时出现或在有症状的肌肉疾病出现之前。手部、腕部和膝部受累明显。这种关节炎对用于治疗肌炎的皮质类固醇有反应。1例患者有侵蚀性关节炎和与急性炎症相关的关节周围钙化，秋水仙碱治疗后似乎有所减轻。滑膜活检标本显示表面纤维蛋白沉积、衬里细胞局灶性缺失和轻度炎症，这些发现与硬皮病相似。通过电子显微镜检查，在滑膜的血管内皮中发现了管状网状结构，与多肌炎的其他组织中所见相同。所有患者均有令人惊讶的肺部表现，提示这组患者的病情可能代表多肌炎的一个独特亚组。
