Myopathies inflammatoires et anticorps anti-PM-Scl : à propos d’une série et revue de la littérature |
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Authors: | I. Marie L. Lahaxe K. Tiev A.-B. Duval-Modeste O. Vittecoq H. Levesque F. Jouen |
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Affiliation: | 1. Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France;2. Service de médecine interne, hôpital Saint-Antoine, 75000 Paris, France;3. Service de dermatologie, CHU de Rouen, 76031 Rouen cedex, France;4. Service de rhumatologie, CHU de Rouen, 76031 Rouen cedex, France;5. Laboratoire d’immunologie, CHU de Rouen, 76031 Rouen cedex, France |
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Abstract: | PurposeThe objectives of this study were to evaluate: (1) the prevalence of anti-PM-Scl antibodies within the framework of antinuclear antibodies detection; and (2) the clinical features and outcome of patients with isolated polymyositis/dermatomyositis.MethodsNine thousand and sixty-four consecutive antinuclear testing data allowed us to evaluate anti-PM-Scl antibody prevalence. Second, we also assessed the characteristics of patients with isolated dermatomyositis/polymyositis and associated anti-PM-Scl antibody.ResultsOver 9064 consecutive antinuclear samples tested for antinuclear antibodies, 3263 (36%) were positive; anti-PM-Scl antibody were positive in nine patients: 0.1% of all sera, 0.2% of sera positive for antinuclear antibodies, 1.2% of sera positive for anti-ENA antibodies. Four of the nine patients with anti-PM-Scl antibody had dermatomyositis (n = 3) and polymyositis (n = 1). Patients with dermatomyositis/polymyositis and anti-PM-Scl antibody exhibited severe complications, as follows: ventilatory insufficiency (n = 2) requiring mechanical ventilation in one case, esophageal involvement requiring enteral feeding (n = 1); also, two of these patients had cancer.ConclusionOur case series suggests that the presence of anti-PM-Scl antibody is not a favorable prognostic factor in patients with dermatomyositis/polymyositis. This type of antibody appears to be associated with lung and esophageal involvement; in addition, anti-PM-Scl antibody may co-exist with malignancy in PM/DM patients. Taken together, we suggest that patients with dermatomyositis/polymyositis and anti-PM-Scl antibody require both initial evaluation for lung/digestive manifestations and cancer and close surveillance. |
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Keywords: | Polymyosite Dermatomyosite Anticorps anti-PM-Scl Pré valence Pronostic |
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