Predictive factors for anti-MDA5 antibody in patients with dermatomyositis: a retrospective multicenter study |
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| Authors: | María Castellanos-Gonzalez Beatriz Butrón Bris Isabel Bielsa Marsol Mónica Munera Campos Ricardo Ruiz-Villaverde Concha Postigo Llorente Almudena Nuno-Gonzalez Jesús Tercedor Sánchez Eva Chavarría Mur Rosa Giménez García Ana Bauza Alonso Gloria Aparicio Español Yolanda Hidalgo García Júlia María Sánchez Schmidt Manuel Almagro Sánchez Esther Roé Crespo Elena de Las Heras Alonso Gonzalo Gallo-Pineda Jose Antonio Avilés Izquierdo David Varillas-Delgado |
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| Affiliation: | 1. Dermatology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain;2. Dermatology Service, Hospital Universitario San Cecilio, Granada, Spain;3. Dermatology Service, Hospital Universitario 12 de Octubre, Madrid, Spain;4. Dermatology Service, Hospital Universitario La Paz, Madrid, Spain;5. Dermatology Service, Hospital Virgen de las Nieves, Granada, Spain;6. Dermatology Service, Hospital Infanta Leonor, Madrid, Spain;7. Dermatology Service, Hospital Universitario Río Hortega, Valladolid, Spain;8. Dermatology Service, Hospital Universitario Son Espases, Palma de Mallorca, Spain;9. Dermatology Service, Hospital Universitari Vall d´Hebron, Barcelona, Spain;10. Dermatology Service, Hospital Universitario Central de Asturias, Oviedo, Spain;11. Dermatology Service, Hospital del Mar, Barcelona, Spain;12. Dermatology Service, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain;13. Dermatology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;14. Dermatology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain;15. Dermatology Service, Hospital Universitario Puerta del Mar, Cádiz, Spain;16. Dermatology Service, Hospital General Gregorio Marañon, Madrid, Spain;17. Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain |
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| Abstract: | Background and objectives : Melanoma differentiation-associated gene 5 antibody (anti-MDA5) in dermatomyositis (DM) is associated with rapidly progressive interstitial lung disease and poor prognosis. Early diagnosis is key to improving the prognosis of these patients. The aim was to confirm cutaneous characteristics in patients with anti-MDA5 dermatomyositis and to explore new diagnostic markers for the presence of anti-MDA5 (anti-MDA5+). Patients and Methods : A multicenter cross-sectional retrospective cohort study of 124 patients diagnosed with DM, of which 37 were anti-MDA5+. Demographic data, laboratory data, and clinical manifestations were collected. Results : Anti-MDA5+ DM is characterized by a distinct mucocutaneous phenotype that includes oral lesions, alopecia, mechanic's hands, palmar and dorsal papules, palmar erythema, vasculopathy, and skin ulceration. We found vasculopathy and digit tip involvement very frequently in anti-MDA5+ patients (p <0.001), being a diagnostic marker of anti-MDA5+ (OR, 12.355; 95% CI 2.850–79.263; p = 0.012 and OR, 7.447; 95% CI 2.103–46.718; p = 0.004, respectively). The presence of ulcers deserves special mention, especially in anti-MDA5+ patients, because in our cohort, up to 97% of the anti-MDA5+ patients had ulcers. Conclusions : In patients with suspected DM with digit tip involvement or vasculopathy, the presence of anti-MDA5 antibodies must be ruled out, as it may be a clinical predictor. |
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| Keywords: | anti-MDA5 arthritis Dermatomyositis ulcers vasculopathy |
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