Polymyositis and dermatomyositis laboratory findings: Difference between revisions

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Revision as of 17:05, 12 April 2018

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
	Anti PL-12	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

↑ Adler BL, Christopher-Stine L (February 2018). "Triggers of inflammatory myopathy: insights into pathogenesis". Discov Med. 25 (136): 75–83. PMID 29579414.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.

[pmid29579414-1] Adler BL, Christopher-Stine L (February 2018). "Triggers of inflammatory myopathy: insights into pathogenesis". Discov Med. 25 (136): 75–83. PMID 29579414.

[pmid25182203-2] 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.

[KhanChristopher-Stine2011-3] 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.

[DoblougGaren2015-4] 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.

[ChinoyFertig2007-5] 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.

[DalakasHohlfeld2003-6] 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.

[DouglasTazelaar2001-7] 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.

[BohanPeter1975-8] 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.

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@@ Line 37: / Line 37: @@
 === Myositis-specific autoantibodies ===
 {|
+!
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Autoantibody
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Antigen
@@ Line 42: / Line 43: @@
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Percentage
 |-
+| rowspan="6" |Antisynthetase
 | align="left" style="background:#F5F5F5;" + |Anti-Jo-1
 | align="left" style="background:#F5F5F5;" + |Histidyl-tRNA synthetase
@@ Line 50: / Line 52: @@
 | 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;" + |
@@ Line 56: / Line 84: @@
 | align="left" style="background:#F5F5F5;" + |
 |-
+|
 | align="left" style="background:#F5F5F5;" + |Anti-SRP
 | align="left" style="background:#F5F5F5;" + |Signal recognition particle
@@ Line 62: / Line 91: @@
 | 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;" + |Transcriptional intermediary factor 1-gamma
@@ Line 75: / Line 99: @@
 | align="left" style="background:#F5F5F5;" + |
 |-
+|
 | align="left" style="background:#F5F5F5;" + |Anti NXP-2 antibody
 | align="left" style="background:#F5F5F5;" + |Nuclear matrix protein
@@ Line 82: / Line 107: @@
 | align="left" style="background:#F5F5F5;" + |
 |-
+|
 | align="left" style="background:#F5F5F5;" + |Anti-SAE antibody
 | align="left" style="background:#F5F5F5;" + |Anti-small ubiquitin-like modifier activating enzyme
@@ Line 88: / Line 114: @@
 | align="left" style="background:#F5F5F5;" + |
 |-
+|
 | align="left" style="background:#F5F5F5;" + |Anti HMGCR antibody
 | align="left" style="background:#F5F5F5;" + |3-hydroxy-3-methylglutaryl-coenzyme A reductase