Polymyositis and dermatomyositis laboratory findings: Difference between revisions

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=== Myositis-specific autoantibodies ===
=== Myositis-specific autoantibodies ===
{|
{|
!
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Autoantibody
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Autoantibody
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Antigen
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Antigen
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Percentage
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Percentage
|-
|-
| rowspan="6" |Antisynthetase
| align="left" style="background:#F5F5F5;" + |Anti-Jo-1
| align="left" style="background:#F5F5F5;" + |Anti-Jo-1
| align="left" style="background:#F5F5F5;" + |Histidyl-tRNA synthetase
| align="left" style="background:#F5F5F5;" + |Histidyl-tRNA synthetase
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
| align="left" style="background:#F5F5F5;" + |Anti Mi-2)
|Anti-PL-7
|Threonyl-tRNA synthetase
|
|
|-
| rowspan="2" align="left" style="background:#F5F5F5;" + |Anti PL-12
| align="left" style="background:#F5F5F5;" + |Alanyl-tRNA synthetase
| align="left" style="background:#F5F5F5;" + |
* Epstein-Barr virus (EBV), adenovirus, and influenza infection
| align="left" style="background:#F5F5F5;" + |
|-
|Alanyl-tRNA
|
|
|-
|Anti-OJ
|Isoleucyl-tRNA synthetase
|
|
|-
|Anti-EJ
|Glycyl-tRNA synthetase 
|
|
|-
|
| align="left" style="background:#F5F5F5;" + |Anti Mi-2
| align="left" style="background:#F5F5F5;" + |Chromodomain helicase DNA binding protein 4
| align="left" style="background:#F5F5F5;" + |Chromodomain helicase DNA binding protein 4
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
|
| align="left" style="background:#F5F5F5;" + |Anti-SRP
| align="left" style="background:#F5F5F5;" + |Anti-SRP
| align="left" style="background:#F5F5F5;" + |Signal recognition particle
| align="left" style="background:#F5F5F5;" + |Signal recognition particle
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
| align="left" style="background:#F5F5F5;" + |Anti PL-12
|
| align="left" style="background:#F5F5F5;" + |Alanyl-tRNA synthetase
| align="left" style="background:#F5F5F5;" + |
* Epstein-Barr virus (EBV), adenovirus, and influenza infection
| align="left" style="background:#F5F5F5;" + |
|-
| align="left" style="background:#F5F5F5;" + |Anti TIF-1γ antibody
| align="left" style="background:#F5F5F5;" + |Anti TIF-1γ antibody
| align="left" style="background:#F5F5F5;" + |Transcriptional intermediary factor 1-gamma
| align="left" style="background:#F5F5F5;" + |Transcriptional intermediary factor 1-gamma
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
|
| align="left" style="background:#F5F5F5;" + |Anti NXP-2 antibody
| align="left" style="background:#F5F5F5;" + |Anti NXP-2 antibody
| align="left" style="background:#F5F5F5;" + |Nuclear matrix protein
| align="left" style="background:#F5F5F5;" + |Nuclear matrix protein
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
|
| align="left" style="background:#F5F5F5;" + |Anti-SAE antibody
| align="left" style="background:#F5F5F5;" + |Anti-SAE antibody
| align="left" style="background:#F5F5F5;" + |Anti-small ubiquitin-like modifier activating enzyme
| align="left" style="background:#F5F5F5;" + |Anti-small ubiquitin-like modifier activating enzyme
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| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
|-
|-
|
| align="left" style="background:#F5F5F5;" + |Anti HMGCR antibody
| align="left" style="background:#F5F5F5;" + |Anti HMGCR antibody
| align="left" style="background:#F5F5F5;" + |3-hydroxy-3-methylglutaryl-coenzyme A reductase
| align="left" style="background:#F5F5F5;" + |3-hydroxy-3-methylglutaryl-coenzyme A reductase

Revision as of 17:05, 12 April 2018

Polymyositis and dermatomyositis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal for patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Laboratory Findings

  • Different laboratory tests may be used to diagnose polymyositis and dermatomyositis and exclude other myopathies which include:[1][2][3][4][5][6][7]
    • Sarcoplasmic enzymes
    • Myositis-specific autoantibodies

Sarcoplasmic enzymes

  • Sarcoplasmic enzymes consistent with the diagnosis of polymyositis and dermatomyositis include:[8]
    • Creatine phosphokinase
    • Aldolase
    • Transaminases
    • Lactic dehydrogenase

Myositis-specific autoantibodies

Autoantibody Antigen Association Percentage
Antisynthetase Anti-Jo-1 Histidyl-tRNA synthetase
  • Antisynthetase syndrome
  • Flare up in spring
  • Epstein-Barr virus (EBV), adenovirus, and influenza infection
Anti-PL-7 Threonyl-tRNA synthetase
Anti PL-12 Alanyl-tRNA synthetase
  • Epstein-Barr virus (EBV), adenovirus, and influenza infection
Alanyl-tRNA
Anti-OJ Isoleucyl-tRNA synthetase
Anti-EJ Glycyl-tRNA synthetase 
Anti Mi-2 Chromodomain helicase DNA binding protein 4
  • Severe dermatomyositis rash without significant lung involvement 
Anti-SRP Signal recognition particle
  • Flare up in fall
Anti TIF-1γ antibody Transcriptional intermediary factor 1-gamma
  • Cancer-associated myositis
  • Juvenile dermatomyositis
Anti NXP-2 antibody Nuclear matrix protein
  • Cancer-associated myositis
  • Juvenile dermatomyositis
Anti-SAE antibody Anti-small ubiquitin-like modifier activating enzyme
  • Cancer-associated myositis
Anti HMGCR antibody 3-hydroxy-3-methylglutaryl-coenzyme A reductase
  • Statin-associated necrotizing autoimmune myopathy (SANAM)
6%

References

  1. Adler BL, Christopher-Stine L (February 2018). "Triggers of inflammatory myopathy: insights into pathogenesis". Discov Med. 25 (136): 75–83. PMID 29579414.
  2. Bodoki L, Nagy-Vincze M, Griger Z, Betteridge Z, Szöllősi L, Dankó K (December 2014). "Four dermatomyositis-specific autoantibodies-anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort". Autoimmun Rev. 13 (12): 1211–9. doi:10.1016/j.autrev.2014.08.011. PMID 25182203.
  3. Khan, Sabiha; Christopher-Stine, Lisa (2011). "Polymyositis, Dermatomyositis, and Autoimmune Necrotizing Myopathy: Clinical Features". Rheumatic Disease Clinics of North America. 37 (2): 143–158. doi:10.1016/j.rdc.2011.01.001. ISSN 0889-857X.
  4. Dobloug, Cecilie; Garen, Torhild; Bitter, Helle; Stjärne, Johan; Stenseth, Guri; Grøvle, Lars; Sem, Marthe; Gran, Jan Tore; Molberg, Øyvind (2015). "Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort". Annals of the Rheumatic Diseases. 74 (8): 1551–1556. doi:10.1136/annrheumdis-2013-205127. ISSN 0003-4967.
  5. Chinoy, H.; Fertig, N.; Oddis, C. V; Ollier, W. E R; Cooper, R. G (2007). "The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis". Annals of the Rheumatic Diseases. 66 (10): 1345–1349. doi:10.1136/ard.2006.068502. ISSN 0003-4967.
  6. Dalakas, Marinos C; Hohlfeld, Reinhard (2003). "Polymyositis and dermatomyositis". The Lancet. 362 (9388): 971–982. doi:10.1016/S0140-6736(03)14368-1. ISSN 0140-6736.
  7. Douglas, William W.; Tazelaar, Henry D.; Hartman, Thomas E.; Hartman, Robert P.; Decker, Paul A.; Schroeder, Darrell R.; Ryu, Jay H. (2001). "Polymyositis–Dermatomyositis-associated Interstitial Lung Disease". American Journal of Respiratory and Critical Care Medicine. 164 (7): 1182–1185. doi:10.1164/ajrccm.164.7.2103110. ISSN 1073-449X.
  8. Bohan, Anthony; Peter, James B. (1975). "Polymyositis and Dermatomyositis". New England Journal of Medicine. 292 (8): 403–407. doi:10.1056/NEJM197502202920807. ISSN 0028-4793.