Comparison of the 2017 EULAR/ACR Criteria with Clinicoserologic Criteria for the Classification of Idiopathic Inflammatory Myopathies in Korean Patients
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Purpose: To investigate correlations between myositis-specific autoantibodies (MSA) or myositis-associated antibodies (MAA) andclinical 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 byPeter and Bohan criteria or 2004 European Neuromuscular Centre (ENMC) criteria. Clinical data were obtained by medical recordreview. 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 myositiswas 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 wasclosely associated with anti-MDA5 and anti-ARS, and DM-specific skin lesions were frequently observed in patients with anti-TIF1γ, anti-SRP, and anti-MDA5. Conclusion: The clinicoserologic criteria based on MSA/MAA positivity could reflect more precise clinical features of IIM. Establishmentof a laboratory system routinely available to screen for MSA/MAA status will be beneficial to provide precise diagnosisand proper management of IIM patients.
Abstract
Purpose: To investigate correlations between myositis-specific autoantibodies (MSA) or myositis-associated antibodies (MAA) andclinical 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 byPeter and Bohan criteria or 2004 European Neuromuscular Centre (ENMC) criteria. Clinical data were obtained by medical recordreview. 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 myositiswas 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 wasclosely associated with anti-MDA5 and anti-ARS, and DM-specific skin lesions were frequently observed in patients with anti-TIF1γ, anti-SRP, and anti-MDA5. Conclusion: The clinicoserologic criteria based on MSA/MAA positivity could reflect more precise clinical features of IIM. Establishmentof a laboratory system routinely available to screen for MSA/MAA status will be beneficial to provide precise diagnosisand proper management of IIM patients.
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