Polymyositis and dermatomyositis laboratory findings

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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

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]^[8]
- Sarcoplasmic enzymes
- Myositis-specific autoantibodies^[9]^[10]

Sarcoplasmic enzymes

Sarcoplasmic enzymes consistent with the diagnosis of polymyositis and dermatomyositis include:^[11]
- Creatine phosphokinase
- Aldolase
- Transaminases
- Lactic dehydrogenase

Myositis-specific autoantibodies

Autoantibody		Antigen	Features	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	Myositis, mechanic's hands, Gottron's papules, arthritis
	Anti PL-12	Alanyl-tRNA synthetase	Fever, Raynaud's phenomenon, high frequency of ILD Epstein-Barr virus (EBV), adenovirus, and influenza infection
	Anti PL-12	Alanyl-tRNA
	Anti-OJ	Isoleucyl-tRNA synthetase
	Anti-EJ	Glycyl-tRNA synthetase
	Anti-KS	Asparaginyl
	Anti-Ha	Tyrosyl
	Anti-Zo	Phenylalanyl
	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–PM-Scl		Overlap of polymyositis and Scleroderma	25%
	Anti-p155/140	Transcriptional intermediary factor 1-gamma	Cancer-associated myositis Juvenile dermatomyositis Severe cutaneous disease	13-21% in IIM 23-29% in JDM
	Anti NXP-2 antibody (Anti-p140)	Nuclear matrix protein	Cancer-associated myositis Juvenile dermatomyositis	23% in JDM
	Anti-SAE antibody	Anti-small ubiquitin-like modifier activating enzyme	Cancer-associated myositis	5%
	Anti–caDM-140	Intracytoplasmic MDA5	Dermatomyositis and rapidly progressive ILD
	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

↑ 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.
↑ Miller, Frederick W. (1993). "Myositis-Specific Autoantibodies". JAMA. 270 (15): 1846. doi:10.1001/jama.1993.03510150080034. ISSN 0098-7484.
↑ Targoff, Ira N. (2006). "Myositis specific autoantibodies". Current Rheumatology Reports. 8 (3): 196–203. doi:10.1007/s11926-996-0025-3. ISSN 1523-3774.
↑ Gunawardena, H.; Betteridge, Z. E.; McHugh, N. J. (2009). "Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression". Rheumatology. 48 (6): 607–612. doi:10.1093/rheumatology/kep078. ISSN 1462-0324.
↑ 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.

[Miller1993-8] Miller, Frederick W. (1993). "Myositis-Specific Autoantibodies". JAMA. 270 (15): 1846. doi:10.1001/jama.1993.03510150080034. ISSN 0098-7484.

[Targoff2006-9] Targoff, Ira N. (2006). "Myositis specific autoantibodies". Current Rheumatology Reports. 8 (3): 196–203. doi:10.1007/s11926-996-0025-3. ISSN 1523-3774.

[GunawardenaBetteridge2009-10] Gunawardena, H.; Betteridge, Z. E.; McHugh, N. J. (2009). "Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression". Rheumatology. 48 (6): 607–612. doi:10.1093/rheumatology/kep078. ISSN 1462-0324.

[BohanPeter1975-11] 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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Polymyositis and dermatomyositis laboratory findings

Overview

Laboratory Findings

Sarcoplasmic enzymes

Myositis-specific autoantibodies

References

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