Association of antinuclear antibody status with clinical features and malignancy risk in adult-onset dermatomyositis - 12/04/19
Abstract |
Background |
The clinical significance of antinuclear antibody (ANA) status in adults with dermatomyositis (DM) has yet to be fully defined.
Objective |
We compared the incidence of amyopathic disease, risk of malignancy, and clinical findings in ANA+ and ANA− patients with adult-onset DM.
Methods |
This was a retrospective cohort study of patients with ANA+ or ANA− adult-onset DM determined by enzyme-linked immunosorbent assay.
Results |
Of 231 patients, 140 (61%) were ANA+ and 91 (39%) were ANA–. Compared with the ANA− patients, the ANA+ patients had a lower frequency of dysphagia (15% vs 26% [P = .033]) and heliotrope rash (38% vs 53% [P = .026]). In all, 54 patients (23%) developed malignancy within 3 years of diagnosis of their DM; 11% of the ANA+ patients developed malignancy versus 43% of the ANA− patients (P < .001). There was a strong association between ANA positivity and lower likelihood of malignancy in multivariable analysis (odds ratio, 0.16; P < .001). Conversely, ANA positivity was not associated with amyopathic disease (odds ratio, 0.94; P = .87).
Limitations |
The retrospective nature of the study was a limitation.
Conclusion |
In patients with adult-onset DM, ANA negativity is associated with increased likelihood of development of malignancy within 3 years of diagnosis of their DM. Particularly close follow-up and frequent malignancy screening may be warranted in ANA− individuals with DM.
Le texte complet de cet article est disponible en PDF.Key words : antinuclear antibody, connective tissue disease, dermatomyositis, inflammatory myopathy, malignancy, paraneoplastic
Abbreviations used : ANA, DM, ELISA, IIF, OR
Plan
Funding sources: None. |
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Conflicts of interest: None disclosed |
Vol 80 - N° 5
P. 1364-1370 - mai 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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