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Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis. Arthritis Rheumatol 2016 Mar;68(3):761-8

Date

10/17/2015

Pubmed ID

26474155

Pubmed Central ID

PMC4767657

DOI

10.1002/art.39466

Scopus ID

2-s2.0-84963803930   27 Citations

Abstract

OBJECTIVE: To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs).

METHODS: Univariable and multivariable multinomial logistic regression analyses were performed in a large juvenile IIM registry (nā€‰=ā€‰365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms.

RESULTS: Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis-specific autoantibodies (multinomial odds ratio [OR] 4.2 and 2.8, respectively), myositis-associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti-p155/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V-sign or shawl sign rashes, and cuticular overgrowth (OR 2.2-3.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2).

CONCLUSION: Our findings indicate that myositis autoantibodies, in particular anti-p155/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified.

Author List

Habers GE, Huber AM, Mamyrova G, Targoff IN, O'Hanlon TP, Adams S, Pandey JP, Boonacker C, van Brussel M, Miller FW, van Royen-Kerkhof A, Rider LG, Childhood Myositis Heterogeneity Study Group

Author

Judyann C. Olson MD Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Autoantibodies
Child
Chronic Disease
Environmental Exposure
Female
Humans
Logistic Models
Male
Myositis
Polymorphism, Genetic
Registries
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280