Arthritis in Idiopathic Inflammatory Myopathy: Clinical Features and Autoantibody Associations

被引:17
作者
Klein, Martin [1 ,2 ]
Mann, Herman [1 ,2 ]
Plestilova, Lenka [1 ,2 ]
Betteridge, Zoe [3 ]
McHugh, Neil [3 ]
Remakova, Martina [1 ,2 ]
Novota, Peter
Vencovsky, Jiri [1 ,2 ]
机构
[1] Charles Univ Prague, Inst Rheumatol, Fac Med 1, Prague, Czech Republic
[2] Charles Univ Prague, Dept Rheumatol, Fac Med 1, Prague, Czech Republic
[3] Royal Natl Hosp Rheumat Dis, Bath BA1 1RL, Avon, England
关键词
IDIOPATHIC INFLAMMATORY MYOPATHIES; ARTHRITIS; AUTOANTIBODIES; OF-THE-LITERATURE; ANTISYNTHETASE SYNDROME; ANTI-JO-1; ANTIBODIES; SINE MYOSITIS; POLYMYOSITIS DERMATOMYOSITIS; RHEUMATOID-ARTHRITIS; DEFORMING ARTHRITIS; MANIFESTATIONS; ARTHROPATHY; DISEASE;
D O I
10.3899/jrheum.131223
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To determine the prevalence, distribution, and clinical manifestations of arthritis in a cohort of patients with idiopathic inflammatory myopathies (IIM). Associations with autoantibody status and HLA genetic background were also explored. Methods. Consecutive patients with IIM treated in a single center were included in this cross-sectional study (n = 106). History of arthritis, 68-joint and 66-joint tender and swollen joint index, clinical features of IIM, and autoantibody profiles were obtained by clinical examination, personal interview, and review of patient records. High-resolution genotyping in HLA-DRB1 and HLA-DQB1 loci was performed in 71 and 73 patients, respectively. Results. A combination of patients' medical history and cross-sectional physical examination revealed that arthritis at any time during the disease course had occurred in 56 patients (53%). It was present at the beginning of the disease in 39 patients (37%) including 23 cases (22%) with arthritis preceding the onset of muscle weakness. On physical examination, 29% of patients had at least 1 swollen joint. The most frequently affected areas were wrists, and metacarpophalangeal and proximal interphalangeal joints. Twenty-seven out of the 29 anti-Jo1-positive patients had arthritis at any time during the course of their illness; this prevalence was significantly higher compared to patients without the anti-Jo1 autoantibody (p < 0.0001). No association of arthritis with individual HLA alleles was found. Conclusion. Our data suggest that arthritis is a common feature of myositis. It is frequently present at the onset of disease and it may even precede muscular manifestations of IIM. The most common presentation is a symmetrical, nonerosive polyarthritis affecting particularly the wrists, shoulders, and small joints of the hands. We have confirmed a strong association of arthritis with the presence of the anti-Jo1 antibody.
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收藏
页码:1133 / 1139
页数:7
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