Polymyositis and dermatomyositis laboratory findings: Difference between revisions

Jump to navigation Jump to search
Line 41: Line 41:
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Antigen
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Antigen
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Association
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Association
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Percentage
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Frequency
|-
|-
| rowspan="6" |Antisynthetase
| rowspan="6" |Antisynthetase
Line 48: Line 48:
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Antisynthetase syndrome
* Antisynthetase syndrome
** Arthritis
** Interstitial lung disease
** Fever
** Mechanic's hands
** Raynaud's phenomenon
* Flare up in spring
* Flare up in spring
* Epstein-Barr virus (EBV), adenovirus, and influenza infection
* Moderate response to treatment
| align="left" style="background:#F5F5F5;" + |
* Poor prognosis
* Associated with epstein-Barr virus (EBV), adenovirus, and influenza infection
| align="left" style="background:#F5F5F5;" + |20-25%
|-
|-
|Anti-PL-7  
|Anti-PL-7  
Line 81: Line 88:
| 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;" + |
* Severe dermatomyositis rash without significant lung involvement 
* Dermatomyositis rash without significant lung involvement
| align="left" style="background:#F5F5F5;" + |
* Acute but mild onset
* Good prognosis
| align="left" style="background:#F5F5F5;" + |5-10%
|-
|-
|
|
Line 88: Line 97:
| align="left" style="background:#F5F5F5;" + |Signal recognition particle
| align="left" style="background:#F5F5F5;" + |Signal recognition particle
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Cardiac involvement and myalgias
* Flare up in fall
* Flare up in fall
| align="left" style="background:#F5F5F5;" + |
* Very acute and severe onset
* Poor response to treatment
* Very poor prognosis
| align="left" style="background:#F5F5F5;" + |<5%
|-
|-
|
|

Revision as of 18:07, 12 April 2018

Polymyositis and dermatomyositis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Polymyositis and dermatomyositis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Polymyositis and dermatomyositis laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Polymyositis and dermatomyositis laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Polymyositis and dermatomyositis laboratory findings

CDC on Polymyositis and dermatomyositis laboratory findings

Polymyositis and dermatomyositis laboratory findings in the news

Blogs on Polymyositis and dermatomyositis laboratory findings

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Polymyositis and dermatomyositis laboratory findings

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 Frequency
Antisynthetase Anti-Jo-1 Histidyl-tRNA synthetase
  • Antisynthetase syndrome
    • Arthritis
    • Interstitial lung disease
    • Fever
    • Mechanic's hands
    • Raynaud's phenomenon
  • Flare up in spring
  • Moderate response to treatment
  • Poor prognosis
  • Associated with epstein-Barr virus (EBV), adenovirus, and influenza infection
20-25%
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
  • Dermatomyositis rash without significant lung involvement
  • Acute but mild onset
  • Good prognosis
5-10%
Anti-SRP Signal recognition particle
  • Cardiac involvement and myalgias
  • Flare up in fall
  • Very acute and severe onset
  • Poor response to treatment
  • Very poor prognosis
<5%
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%
Others Anti-FER Elongation factor 1 alpha
Anti-KJ Unidentified cytoplasmic protein 
Anti-MAS Unidentified cytoplasmic RNA

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.