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Arthritis in idiopathic inflammatory myopathy: clinical features and autoantibody associations

M. Klein, H. Mann, L. Pleštilová, Z. Betteridge, N. McHugh, M. Remáková, P. Novota, J. Vencovský,

. 2014 ; 41 (6) : 1133-9.

Jazyk angličtina Země Kanada

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc15014344

OBJECTIVE: To determine the prevalence, distribution, and clinical manifestations of arthritis in a cohort of patients with idiopathic inflammatory myopathies (IIM). Associations with autoantibody status and HLA genetic background were also explored. METHODS: Consecutive patients with IIM treated in a single center were included in this cross-sectional study (n = 106). History of arthritis, 68-joint and 66-joint tender and swollen joint index, clinical features of IIM, and autoantibody profiles were obtained by clinical examination, personal interview, and review of patient records. High-resolution genotyping in HLA-DRB1 and HLA-DQB1 loci was performed in 71 and 73 patients, respectively. RESULTS: A combination of patients' medical history and cross-sectional physical examination revealed that arthritis at any time during the disease course had occurred in 56 patients (53%). It was present at the beginning of the disease in 39 patients (37%) including 23 cases (22%) with arthritis preceding the onset of muscle weakness. On physical examination, 29% of patients had at least 1 swollen joint. The most frequently affected areas were wrists, and metacarpophalangeal and proximal interphalangeal joints. Twenty-seven out of the 29 anti-Jo1-positive patients had arthritis at any time during the course of their illness; this prevalence was significantly higher compared to patients without the anti-Jo1 autoantibody (p < 0.0001). No association of arthritis with individual HLA alleles was found. CONCLUSION: Our data suggest that arthritis is a common feature of myositis. It is frequently present at the onset of disease and it may even precede muscular manifestations of IIM. The most common presentation is a symmetrical, nonerosive polyarthritis affecting particularly the wrists, shoulders, and small joints of the hands. We have confirmed a strong association of arthritis with the presence of the anti-Jo1 antibody.

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$a Klein, Martin $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Arthritis in idiopathic inflammatory myopathy: clinical features and autoantibody associations / $c M. Klein, H. Mann, L. Pleštilová, Z. Betteridge, N. McHugh, M. Remáková, P. Novota, J. Vencovský,
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$a OBJECTIVE: To determine the prevalence, distribution, and clinical manifestations of arthritis in a cohort of patients with idiopathic inflammatory myopathies (IIM). Associations with autoantibody status and HLA genetic background were also explored. METHODS: Consecutive patients with IIM treated in a single center were included in this cross-sectional study (n = 106). History of arthritis, 68-joint and 66-joint tender and swollen joint index, clinical features of IIM, and autoantibody profiles were obtained by clinical examination, personal interview, and review of patient records. High-resolution genotyping in HLA-DRB1 and HLA-DQB1 loci was performed in 71 and 73 patients, respectively. RESULTS: A combination of patients' medical history and cross-sectional physical examination revealed that arthritis at any time during the disease course had occurred in 56 patients (53%). It was present at the beginning of the disease in 39 patients (37%) including 23 cases (22%) with arthritis preceding the onset of muscle weakness. On physical examination, 29% of patients had at least 1 swollen joint. The most frequently affected areas were wrists, and metacarpophalangeal and proximal interphalangeal joints. Twenty-seven out of the 29 anti-Jo1-positive patients had arthritis at any time during the course of their illness; this prevalence was significantly higher compared to patients without the anti-Jo1 autoantibody (p < 0.0001). No association of arthritis with individual HLA alleles was found. CONCLUSION: Our data suggest that arthritis is a common feature of myositis. It is frequently present at the onset of disease and it may even precede muscular manifestations of IIM. The most common presentation is a symmetrical, nonerosive polyarthritis affecting particularly the wrists, shoulders, and small joints of the hands. We have confirmed a strong association of arthritis with the presence of the anti-Jo1 antibody.
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$a Mann, Heřman, $d 1973- $7 nlk20010095506 $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Pleštilová, Lenka $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Betteridge, Zoe $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a McHugh, Neil $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Remáková, Martina $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Novota, Peter $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague.
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$a Vencovský, Jiří $u From the Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; and the Royal National Hospital for Rheumatic Diseases, Bath, UK.M. Klein, MD; H. Mann, MD; L. Pleštilová, MD, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; Z. Betteridge, PhD; N. McHugh, MD, Professor, Royal National Hospital for Rheumatic Diseases; M. Remáková, MSc, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague; P. Novota, Dr, Institute of Rheumatology; J. Vencovský, MD, Professor, Institute of Rheumatology, and the Department of Rheumatology, First Faculty of Medicine, Charles University in Prague. vencovsky@revma.cz.
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