Clinical analysis of elderly patients with anti-MDA5 antibody-positive dermatomyositis
10.3760/cma.j.issn.0254-9026.2022.09.010
- VernacularTitle:老年抗黑色素瘤分化相关基因抗体阳性皮肌炎回顾性临床分析
- Author:
Jia WANG
1
;
Jiafen LIAO
;
Ni MAO
;
Qi TANG
;
Shu LI
;
Fen LI
;
Jinwei CHEN
;
Xi XIE
Author Information
1. 中南大学湘雅二医院风湿免疫科，长沙 410011
- Keywords:
Dermatomyositis;
Anti-MDA5 antibody;
Clinical characteristics
- From:
Chinese Journal of Geriatrics
2022;41(9):1066-1070
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the clinical characteristics of elderly patients with anti-MDA5 antibody-positive dermatomyositis.Methods:Data of 62 patients with anti-MDA5 antibody-positive dermatomyositis admitted to Second Xiangya Hospital from May 2016 to December 2019 were collected and patients were divided into an elderly group(≥60 years old, 17 cases)and a non-elderly group(<60 years old, 45 cases). The clinical manifestations, laboratory test resuls, treatment and prognosis of the patients in both groups were statistically analyzed.Results:A total of 62 patients with anti-MDA5 antibody-positive dermatomyositis were included in this study, including 17 elderly patients(27.4%)with an average age of(65.5±5.3)years and 45 non-elderly patients(72.6%)with an average age of(46.5±8.4)years.Compared with non-elderly patients, older patients had a shorter disease duration[(1.6±1.0)months vs.(3.7±3.3)months, t=3.883, P<0.001], a higher proportion of patients with exertional dyspnea(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024)and with combined positive anti-Ro-52 antibodies(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024), and a higher mortality rate[(12/17 or 70.6%) vs.(8/45 or 17.8%, χ2=15.748, P<0.001)]. In contrast, fewer elderly patients than non-elderly patients had the Heliotrope's sign(9/17 or 41.2% vs.38/45 or 57.8%), χ2=5.07, P=0.024). Conclusions:Elderly patients with anti-MDA5 antibody-positive dermatomyositis have a unique clinical phenotype with an acute onset, atypical rashes, severe pulmonary lesions, making treatment difficult, and have a poor prognosis.
