Comparison of clinical and laboratory features and treatment responses in patients with clinically amyopathic juvenile dermatomyositis and classical juvenile dermatomyositis.
clinically amyopathic juvenile dermatomyositis
pediatric rheumatology
treatment
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
revised:
22
05
2023
received:
26
12
2022
accepted:
23
05
2023
medline:
2
8
2023
pubmed:
8
6
2023
entrez:
8
6
2023
Statut:
ppublish
Résumé
The aim of this study was to compare the clinical and laboratory features, treatment choices and responses, and outcomes between patients with clinically amyopathic juvenile dermatomyositis (CAJDM) and classical juvenile dermatomyositis (JDM). We retrospectively reviewed the medical records of patients with CAJDM and JDM, and compared the 2 groups' clinical and laboratory data, treatment agents and responses, and outcomes. There were 38 JDM and 12 CAJDM patients, with female dominance. There was a higher delay time in diagnosis for CAJDM (P = 0.000). Compared to other clinical symptoms of JDM, muscle weakness and myalgia were more prominent in JDM than in CAJDM (P = 0.000). The absolute lymphocyte count was lower (P = 0.034) in patients with JDM than in those with CAJDM. Anti-p155/140 (TIF-1) antibody positivity was significantly more common in the CAJDM group (P = 0.000), while anti-NXP2 antibody was more common in the JDM group (P = 0.046). In terms of treatment, pulse corticosteroid usage was more common in patients with JDM than in those with CAJDM (P = 0.000). Close clinical follow-ups with effective treatments are important to prevent complications, such as calcinosis and skin ulcers, that may develop in patients with poorly controlled CAJDM. Anti-p155/140 antibodies may be a useful indicator for detecting amyopathic forms of dermatomyositis in children.
Identifiants
pubmed: 37288472
doi: 10.1111/1756-185X.14773
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1504-1511Informations de copyright
© 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Références
Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet. 2008;371:2201-2212.
Symmons DP, Sills JA, Davis SM. The incidence of juvenile dermatomyositis: results from a nation-wide study. Br J Rheumatol. 1995;34:732-736.
Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344-347.
Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975;292:403-407.
Gerami P, Walling HW, Lewis J, Doughty L, Sontheimer RD. A systematic review of juvenile-onset clinically amyopathic dermatomyositis. Br J Dermatol. 2007;157:637-644.
Bailey EE, Fiorentino DF. Amyopathic dermatomyositis: definitions, diagnosis, and management. Curr Rheumatol Rep. 2014;16:465.
Gerami P, Schope JM, McDonald L, Walling HW, Sontheimer RD. A systematic review of adult-onset clinically amyopathic dermatomyositis (dermatomyositis siné myositis): a missing link within the spectrum of the idiopathic inflammatory myopathies. J Am Acad Dermatol. 2006;54:597-613.
Oberle EJ, Bayer ML, Chiu YE, Co DO. How often are pediatric patients with clinically amyopathic dermatomyositis truly amyopathic? Pediatr Dermatol. 2017;34:50-57.
Mamyrova G, Kishi T, Targoff IN, et al. Features distinguishing clinically amyopathic juvenile dermatomyositis from juvenile dermatomyositis. Rheumatology (Oxford). 2018;57:1956-1963.
Pagnini I, Vitale A, Selmi C, Cimaz R, Cantarini L. Idiopathic inflammatory myopathies: an update on classification and treatment with special focus on juvenile forms. Clin Rev Allergy Immunol. 2017;52:34-44.
Sontheimer RD. Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis siné myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness? J Am Acad Dermatol. 2002;46:626-636.
Huber AM, Feldman BM, Rennebohm RM, et al. Validation and clinical significance of the childhood myositis assessment scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies. Arthritis Rheum. 2004;50:1595-1603.
Barut K, Aydin PO, Adrovic A, et al. Juvenile dermatomyositis: a tertiary center experience. Clin Rheumatol. 2017;36:361-366.
Bellutti Enders F, Bader-Meunier B, Baildam E, et al. Consensus-based recommendations for the management of juvenile dermatomyositis. Ann Rheum Dis. 2017;76:329-340.
Malek A, Raeeskarami SR, Ziaee V, Aghighi Y, Moradinejad MH. Clinical course and outcomes of Iranian children with juvenile dermatomyositis and polymyositis. Clin Rheumatol. 2014;33:1113-1118.
Tansley S, Wedderburn LR. Comparing and contrasting clinical and serological features of juvenile and adult-onset myositis. Curr Opin Rheumatol. 2015;27:601-607.
Tansley SL, Simou S, Shaddick G, et al. Autoantibodies in juvenile-onset myositis: their diagnostic value and associated clinical phenotype in a large UK cohort. J Autoimmun. 2017;84:55-64.
Wu JQ, Lu MP, Reed AM. Juvenile dermatomyositis: advances in clinical presentation, myositis-specific antibodies and treatment. World J Pediatr. 2020;16:31-43.
Bobirca A, Alexandru C, Musetescu AE, et al. Anti-MDA5 amyopathic dermatomyositis - a diagnostic and therapeutic challenge. Life (Basel). 2022;12:1108.
Kim S, Kahn P, Robinson AB, et al. Childhood arthritis and rheumatology research alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease. Pediatr Rheumatol Online J. 2017;15:1.
Varnier GC, Pilkington CA, Wedderburn LR. Juvenile dermatomyositis: novel treatment approaches and outcomes. Curr Opin Rheumatol. 2018;30:650-654.
Patil A, Lu J, Kassir M, Babaei M, Goldust M. Adult and juvenile dermatomyositis treatment. J Cosmet Dermatol. 2022;22:395-401. doi:10.1111/jocd.15363