Anti-Ku antibodies: important points to consider

Mähler, Michael; Satoh, Minoru; Fritzler, Marvin J.

doi:10.1136/annrheumdis-2019-216535

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…This is in keeping with the fact that CK in IIM patients tend to be the higher in Juvenile Polymyositis compared to JDM. (14) This study found a 60% ANA Positivity rate which is similar to the 70% reported by Shah M. et al (14) Myositis Speci c antibody panels and Myositis Associated Antibodies panels are not available in the public setting at SWRHA and may account for the low testing seen in the notes reviewed. However, a few notable observations on autoantibodies done from Extractable Nuclear Antigen-23 testing was discovered.…”

Section: Disease Activitysupporting

confidence: 81%

Juvenile Idiopathic Inflammatory Myopathy and Juvenile Dermatomyositis: Characteristics and outcomes of affected children at a Paediatric Rheumatology Clinic in a tropical climate.

Latchan

Ali

Chin-Kong

et al. 2022

Preprint

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Background Juvenile Idiopathic Inflammatory Myopathy (JIIM) is a rare autoimmune condition of which Juvenile Dermatomyositis (JDM) is the most common subtype. To this date there has been no published data focusing on this condition in Trinidad nor the English-speaking Caribbean. Methods A retrospective folder analysis was done on patients with JIIM who attended the recently formed Paediatric Rheumatology Multi-Disciplinary Clinic over a 6 months period from May 2021 at San Fernando Teaching Hospital, Trinidad and Tobago. Demographics, investigations and diagnoses were analysed. A secondary comparative analysis of two diagnostic criteria was performed and treatment approach was examined. Results 5 notes were reviewed in this period. The male: female ratio was 1:4 and the average age of onset was 6.8 years. 80% of JIIM cases were JDM. The most common presenting complaints were: skin rash and weakness (62%). The most common additional symptoms were: joint pain (60%) and pruritis (60%). Previous upper respiratory tract infection was recognized in 40% of JIIM patients and one patient had Kawasaki disease 6 years prior. Creatine Kinase showed modest elevations in JDM, whilst it was extremely elevated in one patient with myositis. There was an 80% concordance between the EULAR/ACR 2017 and the Peter and Bohan 1975 criteria. 60% tested positive for ANA. Anti PM, Anti Ku, Anti RP155, Anti Mi2A, Anti Mi2B and Anti RP11 antibodies were identified. 40% were positive for AntiRP155. 60% of patients utilized MRI imaging which detected myositis in all reports. Methotrexate and prednisolone were used in 100%. Parenteral drugs used included: intravenous immunoglobulin and methylprednisolone. 80% had vitamin D supplementation and 100% were prescribed physiotherapy. One child had intractable calcinosis. Conclusions Whilst the study size was arguably small, patterns were seen which are in keeping with international data on epidemiology and treatment. Recommendations from this study include: greater utilization of MRI in diagnostic workup, further evaluating anti RP155 antibody as a new myositis associated antibody in a Caribbean population and exploring further options for calcinosis treatment in a developing nation.

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Section: Disease Activitysupporting

confidence: 81%

Juvenile Idiopathic Inflammatory Myopathy and Juvenile Dermatomyositis: Characteristics and outcomes of affected children at a Paediatric Rheumatology Clinic in a tropical climate.

Latchan

Ali

Chin-Kong

et al. 2022

Preprint

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“…We thank the authors1 for their interest in our paper2 and are grateful for the opportunity to respond to the points raised. We agree with the opinion of Mahler et al that ‘SLE frequently express many autoantibodies and sera accompanied by mixed HEp-2 IIF pattern were very common’.…”

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confidence: 99%

“…These kits are commonly used in Japan and are covered by health insurance for clinical laboratory tests. As Mahler et al noted that there is variability between anti-dsDNA assays,1 we need to use immunofluorescence tests with Crithidia luciliae as a substrate for confirmation.…”

mentioning

confidence: 99%

Response to: ‘Anti-Ku antibodies: important points to consider’ by Mahler et al

Ogawa‐Momohara

Muro

Akiyama

2021

Annals of the Rheumatic Diseases

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We thank the authors 1 for their interest in our paper 2 and are grateful for the opportunity to respond to the points raised. We agree with the opinion of Mahler et al that 'SLE frequently express many autoantibodies and sera accompanied by mixed HEp-2 IIF pattern were very common'. We adopted the same methods for anti-Ku screening that Spielmann et al 3 used in their study to avoid missing multiple autoantibody-positive cases. The Spielmann group included ANA-positive sera showing several ANA patterns (ICAP nomenclature: AC-1, AC-4 or AC-5) for ELISA analysis.Although Mahler et al noted that 'In our experience, anti-Ku antibodies are frequently found in SLE patients potentially associated with overlap features of a myopathy', of the four anti-Ku antibody-positive myositis patients in their referenced study, only two patients had systemic lupus erythematosus (SLE) overlapping with myositis. 3 Given that 33 anti-Ku-positive SLE patients in their study 4 did not have myositis, it seems that SLE and myositis are less likely to overlap. We need to be careful in discussing the frequency of anti-Ku-associated clinical phenotypes.We detected anti-dsDNA and anti-ssDNA antibodies by using two commercial ELISA kits (MBL, Nagoya, Japan). These kits are commonly used in Japan and are covered by health insurance for clinical laboratory tests. As Mahler et al noted that there is variability between anti-dsDNA assays, 1 we need to use immunofluorescence tests with Crithidia luciliae as a substrate for confirmation.

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Anticorps anti-Ku et associations cliniques

Nespola

Goetz

2022

Revue Francophone des Laboratoires

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Anti-Ku antibodies: important points to consider

Cited by 4 publications

References 19 publications

Juvenile Idiopathic Inflammatory Myopathy and Juvenile Dermatomyositis: Characteristics and outcomes of affected children at a Paediatric Rheumatology Clinic in a tropical climate.

Juvenile Idiopathic Inflammatory Myopathy and Juvenile Dermatomyositis: Characteristics and outcomes of affected children at a Paediatric Rheumatology Clinic in a tropical climate.

Response to: ‘Anti-Ku antibodies: important points to consider’ by Mahler et al

Anticorps anti-Ku et associations cliniques

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