1.Profile of various idiopathic inflammatory myopathies at two university hospitals in Yangon, Myanmar
Ohnmar ; Zin Phyu Tun ; Cho Cho Nyunt ; Su Lei Htay ; Soe Lin Oo ; Cho Mar Lwin ; Yin Minn Soe ; Chit Soe ; Win Min Thit
Neurology Asia 2020;25(3):285-291
Objective: to determine the distribution of various idiopathic inflammatory myopathies (IIM) and
their profile at the largest university hospitals in Yangon, Myanmar. Method: It was a hospital based
prospective study recruiting IIM patients admitted to Neurology and Rheumatology ward over a 1.5
year period from September 2017 to February 2019. Results: Among total 51 IIM patients recruited,
62.7% presented to Neurology ward and 37.3% to Rheumatology ward. Overlap myositis (OM)
was the commonest (43%), followed by immune-mediated necrotizing myopathy (IMNM) 27%,
dermatomyositis (DM) 24%, polymyositis (PM) 6%. Among OM, anti-synthetase syndrome (ASS)
was 23%, and among IMNM, anti-SRP positive was 79%. IMNM and PM patients presented more
to neurologists while OM/ASS and DM more to rheumatologists; 82% were females (F:M= 4.6:1).
Mean age of onset of myositis was 40.2 + 17.8 years, and duration of symptoms before presentation
was 10-3,600 days (shortest in anti-SRP and longest in anti-HMGCR myopathy). Myositis antibodies
were positive in 67%. CK range was 40-25,690 U/l, highest in IMNM and lowest in DM. Associated
connective tissue diseases among OM in order of descending frequency were 47% systemic lupus
erythematosus, 24% Sjogren syndrome, 41% scleroderma and 12% rheumatoid arthritis. Associated
cancer identified were one lung cancer in DM, one breast cancer in OM, one buccal cancer in IMNM
cases.
Conclusions: With recent availability of myositis antibody panel and MHC staining in Myanmar, we
have applied current updated classification to describe the first Myanmar data on IIM cases.