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Horiuchi Y, Hashimoto K, Yoshida R, Sekizawa A, Kubota A, Maeda M, Toda T, Tanaka Y. Severe finger necrosis in antisynthetase syndrome with positive anti-OJ antibodies. Clin Case Rep 2024; 12:e8990. [PMID: 38831985 PMCID: PMC11144602 DOI: 10.1002/ccr3.8990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/08/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
Key Clinical Message In a patient with anti-aminoacyl tRNA synthetase antibody and anti-OJ antibody syndrome, interventions likes warming, prostaglandins, and antiplatelets failed. However, prednisolone pulse treatment rapidly halted disease progression. Patients with mild interstitial pneumonia, myositis, and extremity necrosis should be promptly considered for anti-synthetase syndrome and receive immunosuppression after ruling out other causes. Abstract Anti-aminoacyl tRNA synthetase (ARS) autoantibodies are myositis-specific, and patients who test positive for ARS and have common clinical features are usually diagnosed with antisynthetase antibody syndrome (antisynthetase syndrome). Anti-ARS antibodies include histidyl-tRNA synthetase-1 (Jo-1), anti-threonyl (PL-7), anti-alanyl (PL-12), anti-glycyl (EJ), anti-asparaginyl (KS), anti-tyrosyl (Ha), and anti-phenylalanyl (Zo) tRNA synthetases. Among these, anti-isoleucyl tRNA synthetase (OJ) autoantibodies are extremely rare, and patients with these are frequently complicated by interstitial pneumonia. We report the case of an older man with ARS antibody syndrome who tested positive for anti-OJ and anti-Sjögren's-syndrome-related antigen A (Ro-52) antibodies. He had muscle weakness due to myositis and unparalleled rapid and severe finger necrosis. Pulsed prednisolone effectively treated the myositis symptoms and terminated the progression of finger necrosis.
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Affiliation(s)
- Yugo Horiuchi
- Department of General MedicineNational Defense Medical CollegeTokorozawaSaitamaJapan
| | - Kenichi Hashimoto
- Department of General MedicineNational Defense Medical CollegeTokorozawaSaitamaJapan
| | - Ryochi Yoshida
- Division of Hematology and Rheumatology, Department of Internal MedicineNational Defense Medical CollegeTokorozawaSaitamaJapan
| | - Akinori Sekizawa
- Department of General MedicineNational Defense Medical CollegeTokorozawaSaitamaJapan
| | | | - Meiko Maeda
- Department of NeurologyThe University of TokyoTokyoJapan
| | - Tatsushi Toda
- Department of NeurologyThe University of TokyoTokyoJapan
| | - Yuji Tanaka
- Department of General MedicineNational Defense Medical CollegeTokorozawaSaitamaJapan
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Ghanbar MI, Danoff SK. Review of Pulmonary Manifestations in Antisynthetase Syndrome. Semin Respir Crit Care Med 2024; 45:365-385. [PMID: 38710221 DOI: 10.1055/s-0044-1785536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Antisynthetase syndrome (ASyS) is now a widely recognized entity within the spectrum of idiopathic inflammatory myopathies. Initially described in patients with a triad of myositis, arthritis, and interstitial lung disease (ILD), its presentation can be diverse. Additional common symptoms experienced by patients with ASyS include Raynaud's phenomenon, mechanic's hand, and fever. Although there is a significant overlap with polymyositis and dermatomyositis, the key distinction lies in the presence of antisynthetase antibodies (ASAs). Up to 10 ASAs have been identified to correlate with a presentation of ASyS, each having manifestations that may slightly differ from others. Despite the proposal of three classification criteria to aid diagnosis, the heterogeneous nature of patient presentations poses challenges. ILD confers a significant burden in patients with ASyS, sometimes manifesting in isolation. Notably, ILD is also often the initial presentation of ASyS, requiring pulmonologists to remain vigilant for an accurate diagnosis. This article will comprehensively review the various aspects of ASyS, including disease presentation, diagnosis, management, and clinical course, with a primary focus on its pulmonary manifestations.
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Affiliation(s)
- Mohammad I Ghanbar
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Sonye K Danoff
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
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Kilinc OC, Ugurlu S. Clinical features of dermatomyositis patients with anti-TIF1 antibodies: A case based comprehensive review. Autoimmun Rev 2023; 22:103464. [PMID: 37863375 DOI: 10.1016/j.autrev.2023.103464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Dermatomyositis is chronic autoimmune disease primarily affecting skin and muscles. Antibodies are key players of pathogenesis and are in strong correlation with distinct clinical phenotypes. We present a case and a comprehensive review of the literature on dermatomyositis patients with Anti TIF1 antibodies. METHODS PubMed and Web of Science databases were reviewed. 166 articles were identified; 95 of them were evaluated; 79 of them included to the study. 45 of the included articles were case reports 9 were case series and 25 were research articles. In total 1065 patients were identified but number of patients with available information for different clinical features varied. RESULTS 69.6% of the patients with Anti TIF1-γ were female. Prevalence of malignancy was 42.6% among patients with Anti TIF1-γ. Muscle weakness (83%), Gottron sign (82.2%), heliotrope rash (73.7%), nailfold capillary changes (67.7%), dysphagia (38.4%), and joint involvement (31.1%) were the most common clinical features seen in patients with Anti TIF1-γ. Interstitial lung disease (ILD) was reported among 8.7% of patients with Anti TIF1-γ. Advanced age, male gender, dysphagia, and V-neck rash were significant risk factors for malignancy, whereas juvenile age, ILD, TIF1-β antibodies and joint involvement were associated with a decreased risk for malignancy. Advanced age, malignancy, dysphagia, and muscle involvement were associated with an increased risk for mortality. CONCLUSIONS Patients with advanced age, male gender, dysphagia, and V-neck rash require strict cancer screening. Patients with advanced age, malignancy, dysphagia, and muscle involvement have poor prognosis and should receive aggressive treatment.
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Affiliation(s)
- Ozgur C Kilinc
- Division of Rheumatology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdal Ugurlu
- Division of Rheumatology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Estrada-Maya J, de Los Ángeles Cuellar M, Vargas LP, Gómez CC, Bonilla A, Burgos PF, Bedoya SA, Oliver MV, Molano N, Linares JS. Unusual presentation of antisynthetase syndrome: a case series and review of the literature. J Med Case Rep 2023; 17:325. [PMID: 37516893 PMCID: PMC10387198 DOI: 10.1186/s13256-023-04040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/06/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Antisynthetase syndrome is an inflammatory myopathy that is characterized by the presence of anti-aminoacyl-tRNA synthetase antibodies. Only 30% of those who suffer from the disease can be identified. We present three Hispanic cases of antisynthetase syndrome with unusual clinical pictures were extended myositis panel results enable disease diagnosis and treatment. CASE PRESENTATION A 57-year-old Hispanic/Latino female with an erythematous scaly plaque, unresolved fever and non-immune haemolytic anaemia in whom inpatient work-up for fever of unknown origin was positive for anti-PL12 positive myositis extended panel. A 72-year-old Hispanic/Latino male with amyopathic weakness syndrome and mechanic hands in whom impatient work-up was relevant for proximal muscle uptake and anti-PM75 and AntiPL-12 myositis extended panel. And a 67-year-old Hispanic/Latino male with progressive interstitial lung disease and unresolved fever ended in myositis extended panel positive for antiPL-7. After systemic immunosuppressor treatment, patients had favourable clinical and paraclinical responses during outpatient follow-up. CONCLUSIONS The high variability of the antisynthetase syndrome in these cases demonstrates the importance of identification through an expanded panel and highlights the probability that this is a variable disease and that we need to include emerging molecular tests to promote the timely treatment of patients.
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Affiliation(s)
- Juan Estrada-Maya
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - María de Los Ángeles Cuellar
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Lina Patricia Vargas
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia.
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
| | - Carmen Cecilia Gómez
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Andrés Bonilla
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Pedro Felipe Burgos
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Alejandro Bedoya
- Internal Medicine, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163ª#13B-60, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | | | - Nicolás Molano
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Bilancini S, Lucchi M, Tucci S, Pomella F, Vittori G, Mollo PE, Trevisan G. Red Palms' Syndrome and Red Fingers' Syndrome: A Mini Review. Angiology 2023:33197231185459. [PMID: 37410889 DOI: 10.1177/00033197231185459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Red palms syndrome consists of an intense redness on the palms of the hands and, occasionally, the soles of the feet. This infrequent condition may be primary or secondary. The primary forms are either familial or sporadic. They are always benign and do not require treatment. The secondary forms may have a poor prognosis related to the underlying disease, for which early identification and treatment are imperative. Red fingers syndrome is also rare. It manifests as a persistent redness on the fingers or toes pulp. It is typically secondary either to infectious diseases like human immunodeficiency virus, hepatitis C virus and chronic hepatitis B or to Myeloproliferative Disorders, such as Thrombocythemia and Polycythemia vera. Manifestations spontaneously regress over months or years without trophic alterations. Treatment is limited to that of the underlying condition. Aspirin has been shown effective in Myeloproliferative Disorders.
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Affiliation(s)
| | - Massimo Lucchi
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | - Sandro Tucci
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | - Federica Pomella
- Department of Angiology, ASL Frosinone (Local Unit of the National Health Service), Frosinone, Italy
| | - Giulia Vittori
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | | | - Giusto Trevisan
- Department of Medical Sciences, University of Trieste, Trieste, Italy
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Nazerani-Zemann T, Stanzel S, Gstettner C, Aigner RM, Pernthaler B. F18-FDG PET/CT in a patient with Antisynthetase Syndrome. Nuklearmedizin 2023; 62:73-74. [PMID: 36599440 PMCID: PMC10063341 DOI: 10.1055/a-1996-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
More prevalent in women than men, Antisynthetase Syndrome is a rare and poorly defined autoimmune disease associated with interstitial lung disease, polymyositis, and dermatomyositis. In addition to various diagnostic tools, imaging modalities are needed in certain situations. A 42-year-old woman with Anti-Jo-1-positive Antisynthetase Syndrome presented with thoracic muscular pain. She underwent whole-body Fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) to evaluate the total extent of the muscles affected. Depicting symptomatic symmetric myositis of the intercostal muscles, F18-FDG PET/CT additionally revealed unusually extensive fasciitis of the lower extremities.
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Affiliation(s)
- Tina Nazerani-Zemann
- Radiology, Division of Nuclear Medicine, Medizinische Universität Graz, Graz, Austria
| | - Susanne Stanzel
- Radiology, Division of Nuclear Medicine, Medizinische Universität Graz, Graz, Austria
| | - Christian Gstettner
- Radiology, Division of Nuclear Medicine, Medizinische Universität Graz, Graz, Austria
| | - Reingard Maria Aigner
- Radiology, Division of Nuclear Medicine, Medizinische Universität Graz, Graz, Austria
| | - Birgit Pernthaler
- Radiology, Division of Nuclear Medicine, Medizinische Universität Graz, Graz, Austria
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Le MH, Dinh HT, Le TTH, Hoang PT, Vu MN, Le DH. The association between clinical, subclinical features and autoantibody profile in Vietnamese dermatomyositis patients. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000979. [PMID: 36962887 PMCID: PMC10021228 DOI: 10.1371/journal.pgph.0000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023]
Abstract
There is still a lack of research in Vietnam on the autoantibody profile of dermatomyositis (DM) and its association with clinical and subclinical characteristics. Therefore, we conducted this study to investigate clinical and subclinical correlations with autoantibodies in DM patients. 72 DM patients at Vietnam National Hospital of Dermatology and Venereology (NHDV) from March 2019 to September 2021 were included in this cross-sectional study. Clinical manifestations and laboratory test results of the patients were obtained at the time of visit. Of these, 63 patients were tested for the presence of autoantibodies using an Immunoblot assay. Our findings show that the average age of patients was 41.7 years. The female-male ratio was 1.7:1. The most common skin and muscle manifestations were myalgia (79.2%), heliotrope rash (62.5%), shawl sign (61.1%), Gottron's sign (59.7%), muscle weakness (59.7%), Gottron's papule (52.8%), periungual telangiectasia (41.7%), V-sign (38.9%), poikiloderma (26.4%), periungual fissures (20.8%), Raynaud's phenomenon (15.3%). Among the 63 patients tested for autoantibodies, myositis-specific antibodies (MSAs) were found in 71.4% of the serum samples, and myositis-associated antibodies (MAAs) in 36.5%. Anti-TIF1γ antibody accounted for the highest percentage (28.6%), followed by anti-Ro52 (22.2%), anti-synthetase (17.5%), anti-Mi-2 and anti-MDA5 (both 14.3%). Anti-synthetase antibodies (ARS-Abs) showed a significant association with arthralgia, fever, and Raynaud's phenomenon, while anti-TIF1γ antibodies showed a strong association with V-sign and poikiloderma (p<0.05). Clinical features in dermatomyositis are heterogeneous. Our study results show some associations between clinical features and autoantibodies in patients with DM. The analysis of DM-related autoantibodies is clinically useful, will be essential for the approaches to diagnosis, and management of DM patients.
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Affiliation(s)
- My Huyen Le
- National Hospital of Dermatology & Venereology, Hanoi, Vietnam
| | - Hoa Thi Dinh
- National Hospital of Dermatology & Venereology, Hanoi, Vietnam
| | - Thu Thi Hoai Le
- National Hospital of Dermatology & Venereology, Hanoi, Vietnam
| | | | - Minh Nguyet Vu
- National Hospital of Dermatology & Venereology, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Doanh Huu Le
- National Hospital of Dermatology & Venereology, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
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Zhang W, Zheng Y, Wang Y, Xiong H, Que C, Zhang X, Zhu Y, Zhao Y, Yu M, Meng L, Lv H, Zhang W, Hao H, Xiao J, Yuan Y, Wang Z. Thigh MRI in antisynthetase syndrome, and comparisons with dermatomyositis and immune-mediated necrotizing myopathy. Rheumatology (Oxford) 2022; 62:310-320. [PMID: 35512205 DOI: 10.1093/rheumatology/keac269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To evaluate MRI changes to define muscle-lesion specific patterns in patients with antisynthetase syndrome (ASS), and compare them with those in other common idiopathic inflammatory myopathy subtypes. METHODS Qualitative and semi-quantitative thigh MRI evaluations were conducted in patients with ASS, DM and immune-mediated necrotizing myopathy (IMNM). RESULTS This study included 51 patients with ASS, 56 with DM and 61 with IMNM. Thigh MRI revealed muscle oedema (62.7%), myofascial oedema (90.2%), subcutaneous-tissue oedema (60.8%) and fatty infiltration of muscles (68.6%) in patients with ASS. Compared with IMNM, ASS and DM were associated with more frequent adductor-muscle relative sparing (40.6% vs 3.6%, P<0.001, and 25.6% vs 3.6%, P<0.001) and subcutaneous-tissue oedema (60.8% vs 23.0%, P<0.001, and 57.1% vs 23.0%, P<0.001). Although ASS and DM exhibited similar oedema patterns, there were certain subtle differences between them. The ASS group was less frequently symmetric (60.6% vs 88.4%, P=0.005, and 60.6% vs 80.0%, P=0.048), but more frequently showed myofascial oedema of the tensor fasciae latae (80.4% vs 48.2%, P<0.001, and 80.4% vs 31.1%, P<0.001) than either the DM or IMNM groups. The receiver operating characteristic curve analysis showed an optimal combination of thigh MRI findings had an area under the curve with 0.893 for diagnosing ASS. CONCLUSION Thigh MRI in ASS exhibited frequent myofascial oedema. ASS oedema patterns resembled those of DM more than those of IMNM. Bilateral asymmetry, adductor-muscle relative sparing and remarkable myofascial oedema of tensor fasciae latae were the most characteristic ASS imaging findings.
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Affiliation(s)
- Wenhao Zhang
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Yiming Zheng
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Yikang Wang
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | | | | | | | - Ying Zhu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yawen Zhao
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Meng Yu
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Lingchao Meng
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - He Lv
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Hongjun Hao
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Jiangxi Xiao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital
- Beijing Key Laboratory of Neurovascular Disease Discovery
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Wang Y, Zheng Y, Zhao Y, Liu Y, Zhang W, Yu M, Xie Z, Hao H, Gao F, Zhang W, Wang Z, Yuan Y. Comparison of cytokine/chemokine profiles between dermatomyositis and anti-synthetase syndrome. Front Neurol 2022; 13:1042580. [PMID: 36570445 PMCID: PMC9772994 DOI: 10.3389/fneur.2022.1042580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives Dermatomyositis (DM) and anti-synthetase syndrome (ASS) are autoimmune diseases with multisystem involvement. Despite sharing some clinical and myopathological features, these are two diseases with different pathogeneses and prognoses. We aimed to clarify and compare cytokine/chemokine profiles in both disorders, which may help in the differential diagnosis. Materials and methods We collected clinical data and serum samples of consecutive patients with DM and ASS. Quantibody® Human Inflammation Array 3 for cytokines/chemokines was performed in the serum of all participants. Receiver operating characteristic analysis with the area under the curve and Youden's index were performed. Results Eight newly diagnosed and treatment-naïve patients with DM, nine newly diagnosed and treatment-naïve patients with ASS, and 14 healthy controls were enrolled. Serum C-C motif chemokine ligand (CCL) 2, CCL4, C-X-C motif chemokine ligand (CXCL) 13, and tumor necrosis factor receptor 2 (TNFR2) were increased in patients with both DM and ASS. Serum interleukin (IL)-1 receptor type 1 (IL-1ra), IL-1b, CCL1, CXCL11, and CCL3 were modulated in patients with DM only, and IL-8, CXCL9, and tissue inhibitors of metalloproteinases-1 (TIMP-1) in patients with ASS only. Serum CCL2, CXCL13, and TNFR2 accurately distinguished patients with DM and ASS from healthy controls, as shown by the area under the curve >0.80. Moreover, receiver operating characteristic analysis showed that, as biomarkers for discrimination between DM and ASS, the combination of IL-1ra and TIMP-1, had an area under the curve of 0.944, a sensitivity of 87.5%, and a specificity of 88.9%. Conclusion Our study demonstrated that serum levels of cytokines/chemokines showed a different pattern in newly diagnosed patients with DM and ASS, in which serum IL-1ra and TIMP-1 could be used to distinguish between the two diseases.
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Affiliation(s)
- Yikang Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yiming Zheng
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yawen Zhao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yilin Liu
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Wenhao Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Meng Yu
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Zhiying Xie
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Hongjun Hao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Feng Gao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China,Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China,Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China,Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China,*Correspondence: Yun Yuan
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The Role of Myositis-Specific Autoantibodies and The Management of Interstitial Lung Disease in Idiopathic Inflammatory Myopathies: A Systematic Review. Semin Arthritis Rheum 2022; 57:152088. [DOI: 10.1016/j.semarthrit.2022.152088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022]
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El-Banna G, Fiorentino D. Update on Cutaneous Signs to Assist in the Diagnosis of Dermatomyositis. Curr Rheumatol Rep 2022; 24:156-165. [PMID: 35404005 DOI: 10.1007/s11926-022-01070-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Dermatomyositis (DM) is a heterogeneous idiopathic inflammatory myopathy that can be challenging to diagnose. Learning about the cutaneous manifestations in DM can assist with prompt diagnosis as well as subgroup classification. This review highlights recent data regarding cutaneous signs in DM and their associations with myositis-specific antibodies (MSAs). RECENT FINDINGS Several novel DM skin signs have recently been reported. Novel and confirmatory data have helped to define more clearly the associations between various cutaneous manifestations and MSAs. Awareness of the diverse cutaneous phenotypes can help with the timely diagnosis of DM. As some MSAs are associated with atypical skin features and/or characteristic patterns of clinical findings, knowledge of these associations can help clinicians to recognize DM patients. Understanding how the prevalence and presentation of various cutaneous signs differ among ethnically diverse patients is a high priority for further study.
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Affiliation(s)
- Ghida El-Banna
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C #C-234, Redwood City, CA, 94063, USA
| | - David Fiorentino
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C #C-234, Redwood City, CA, 94063, USA.
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Patel J, Ravishankar A, Maddukuri S, Vazquez T, Grinnell M, Werth VP. Highly multiplexed imaging mass cytometry identifies similarities between antisynthetase syndrome and dermatomyositis skin lesions. Arthritis Rheumatol 2021; 74:882-891. [PMID: 34905301 PMCID: PMC9194682 DOI: 10.1002/art.42050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/31/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Antisynthetase syndrome (AS) and Dermatomyositis (DM) are autoimmune disorders that overlap clinically. Given the presence of DM skin lesions in AS patients, there is debate about whether AS is distinct or a subclassification of DM. Recently studies identified differences in type I interferon (IFN) between AS and DM muscle and finger eruptions. The aim of this study is to elucidate cutaneous disease pathogenic similarities and differences on a single cell level. METHODS Five AS and seven DM patients were recruited from a prospectively collected database of well-characterized DM patients. AS patients were clinically confirmed with anti-synthetase syndrome by the Connors and Solomon et al. criteria and aminoacyl-transfer ribonucleic acid synthetase antibodies. Immunophenotyping conducted using immunofluorescence (IF) and imaging mass cytometry (IMC). RESULTS IF revealed type I IFN upregulation in AS and DM compared to HC using MxA and IFNβ expression (p<0.05). IMC showed similar macrophages, T cells, B cells, and dendritic cells in AS and DM with no differences in counts (p>0.05), but an increase in myeloid dendritic cell percentage in DM (p<0.05). Key type I IFN, cytokine, and JAK-STAT pathways were similarly expressed in AS and DM (p>0.05). At a single cell level, pSTING+ macrophages in AS expressed increased TNFα, IL17, and IFNβ (p<0.001). CONCLUSION IMC is a powerful tool that identifies a role for the type I IFN system in DM-like skin lesions of AS and DM with some differences at a cellular level, but overall significant overlap exists supporting similar therapeutic decision making.
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Affiliation(s)
- Jay Patel
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Adarsh Ravishankar
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Spandana Maddukuri
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Thomas Vazquez
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Madison Grinnell
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Victoria P Werth
- Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia, PA.,Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
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13
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Phuong TNT, Ngoc LNT, Rönnelid J, Padyukov L, Lundberg IE. Clinical characteristics of Vietnamese patients with idiopathic inflammatory myopathies and autoantibodies to aminoacyl-transfer RNA synthetases. Int J Rheum Dis 2021; 24:663-670. [PMID: 33788398 DOI: 10.1111/1756-185x.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess clinical phenotypes of anti-aminoacyl-transfer RNA synthetases (aaRS) autoantibodies in Vietnamese patients of Kinh ethnicity with idiopathic inflammatory myopathies (IIM). METHODS In a cross-sectional study 23 patients with anti-aaRS autoantibodies were compared to 36 patients with other myositis-specific antibodies and to 69 seronegative patients with IIM. Assessments included muscle performance, extra-muscular involvement, and disease activity according to the International Myositis Assessment and Clinical Studies (IMACS). Sera were tested by a line immunoassay (Euroline Myositis Profile 4). RESULTS The frequency of anti-Jo-1 antibodies was 56.5%, anti-EJ antibodies 26.1%, and anti-PL-7 antibodies 17.4%, while anti-PL-12 and anti-OJ antibodies were not present in any case. All patients with anti-aaRS autoantibodies had signs of myositis. At time of investigation 22/23 patients had muscle weakness, 52.2% arthritis, 34.8% Raynaud's phenomenon, 73.9% fever, 14.3% mechanic's hands and 56.5% dysphagia. Interstitial lung disease was present in 52.2%, and pulmonary hypertension in 56.5%. The anti-aaRS autoantibody positive group had higher disease activity in the domains of skin and pulmonary disease compared to the seronegative group and had lower disease activity in skeletal disease compared to the anti-melanoma differentiation-associated protein 5-positive patients. The clinical presentation of antisynthetase syndrome was similar between the aaRS autoantibody specificities with the exception of more frequent pulmonary hypertension in anti-Jo-1 positive patients. CONCLUSIONS Different aaRS autoantibody specificities may vary between different ethnic populations for reasons that still need to be clarified. Furthermore, the high frequency of pulmonary hypertension is noteworthy but otherwise clinical manifestations associated with aaRS autoantibodies did not differ from other ethnic populations.
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Affiliation(s)
- Thuy Nguyen Thi Phuong
- Rheumatology Department, Bach Mai Hospital, Hanoi, Vietnam.,Internal Medicine Department, Hanoi Medical University, Hanoi, Vietnam
| | | | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Leonid Padyukov
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Rheumatology clinic, Karolinska University Hospital, Stockholm, Sweden
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14
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Caractéristiques cliniques des myosites associées aux anticorps anti-NXP2 chez l’adulte : étude de 6 cas. Ann Dermatol Venereol 2020; 147:891-897. [DOI: 10.1016/j.annder.2020.09.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
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15
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Marco JL, Collins BF. Clinical manifestations and treatment of antisynthetase syndrome. Best Pract Res Clin Rheumatol 2020; 34:101503. [PMID: 32284267 DOI: 10.1016/j.berh.2020.101503] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Antisynthetase syndrome (ASyS) is an autoimmune disease clinically manifested most often by interstitial lung disease, myositis, and arthritis. Raynaud's syndrome, fever, and rashes are also commonly seen. This syndrome is characterized by the highly specific presence of antibodies against various aminoacyl transfer RNA synthetases, including Jo-1 and others. In this chapter, we provide an overview of ASyS, including pathogenesis, common clinical manifestations, and treatment strategies. We discuss the spectrum of disease seen with specific antisynthetase antibodies and examine the differences in phenotype between patients with different antisynthetase antibodies. We outline common treatment strategies, which should generally target the most severe and life- or organ-threatening disease manifestations. Finally, we discuss short- and long-term prognosis in ASyS.
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Affiliation(s)
- Joanna L Marco
- University of Washington, Department of Medicine, Division of Rheumatology, 1959 NE Pacific Street, Box 356428, Seattle, WA, 98195-6522, USA.
| | - Bridget F Collins
- University of Washington Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, 1959 NE Pacific Street, Box 356166, Seattle, WA, 98195, USA.
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16
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Human diseases linked to cytoplasmic aminoacyl-tRNA synthetases. BIOLOGY OF AMINOACYL-TRNA SYNTHETASES 2020; 48:277-319. [DOI: 10.1016/bs.enz.2020.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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