Comparison of the 2017 EULAR/ACR Criteria with Clinicoserologic Criteria for the Classification of Idiopathic Inflammatory Myopathies in Korean Patients
10.3349/ymj.2021.62.5.424
- Author:
Sang Wan CHUNG
1
;
In Seol YOO
;
Jinhyun KIM
;
Seong Wook KANG
;
Mihye KWON
;
Chung-Il JOUNG
;
In Ah CHOI
;
Sung Hae CHANG
;
Mi Il KANG
;
Seung-Jae HONG
;
Yeon-Ah LEE
Author Information
1. Division of Rheumatology, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Publication Type:Original Article
- From:Yonsei Medical Journal
2021;62(5):424-430
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:To investigate correlations between myositis-specific autoantibodies (MSA) or myositis-associated antibodies (MAA) and clinical features, thereby demonstrating the utility of clinicoserologic classification in idiopathic inflammatory myopathies (IIM) patients.
Materials and Methods:We conducted a multicenter study of 108 adult patients (age ≥18 years) who were diagnosed with IIM by Peter and Bohan criteria or 2004 European Neuromuscular Centre (ENMC) criteria. Clinical data were obtained by medical record review. Immunoblot assay with Euroline strip (EUROIMMUN, Germany) was performed using the sera of dermatomyositis (DM, n=56), polymyositis (PM, n=45), amyopathic DM (n=5), DM sine dermatitis (n=1), and immune mediated necrotizing myopathy (n=1) patients. Patients were classified based on two classifications: 2017 EULAR/ACR and novel clinicoserologic classification.
Results:According to 2017 EULAR/ACR criteria, DM and PM were the most and the second most frequent entities. Overlap myositis was the major entity of IIM, and the frequency of PM was significantly lower when applying clinicoserologic classification criteria. Sixty-nine (63.9%) patients had one or more MSA, and 61 (56.5%) patients had one or more MAA. Interstitial lung disease was closely associated with anti-MDA5 and anti-ARS, and DM-specific skin lesions were frequently observed in patients with antiTIF1γ, anti-SRP, and anti-MDA5.
Conclusion:The clinicoserologic criteria based on MSA/MAA positivity could reflect more precise clinical features of IIM. Establishment of a laboratory system routinely available to screen for MSA/MAA status will be beneficial to provide precise diagnosis and proper management of IIM patients.