Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study

Abstract

BackgroundThis study aimed to estimate the point prevalence of myositis and identify associated variables of myositis in systemic lupus erythematosus (SLE).Material/MethodsClinical date of patients hospitalized with lupus at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital were collected. Patients were defined as having myositis if they reported the presence of persistent invalidating muscular weakness combined with increased levels of creatine phosphokinase (CPK) and abnormal electromyography (EMG).ResultsThe study sample comprised 1701 lupus patients, of which 44 had myositis. Patients with SLE-associated myositis are more likely to have skin rash, alopecia, pericarditis, vasculitis, anti-Sm, anti-RNP, anti-dsDNA, thrombocytopenia, leukopenia, low C3, low C4, high erythrocyte sedimentation rate (ESR), high D-dimer, and active disease. Multivariate logistic regression found positive associations between leukopenia, alopecia, and active disease with myositis. Negative associations between myositis with the use of corticosteroids or immunosuppressive drugs were revealed in univariate and multivariate analysis.ConclusionsThe point prevalence of myositis was 2.6% in SLE patients. The significant association of alopecia, leukopenia, and active disease with myositis suggests that organ damage, hematological abnormality, and high disease activity promote the progression of myositis in lupus patients.

Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a single-center experience with 63 patients

“…Convincing evidence about management of cases with less frequent manifestations, such as gastrointestinal and muscular, is scarce. 22,23 In our study, there was a notorious improvement in the SLEDAI-2K scores when compared to partially improved SLEDAI-2K scores in one patient with SLE and myositis in a previous study. 12 On the other hand, several case reports and evidence of IVIG in isolated inflammatory myopathies have been described, 24,25 suggesting IVIG’s benefits where muscular involvement is present.…”

The majority of Swedish systemic lupus erythematosus patients are still affected by irreversible organ impairment: factors related to damage accrual in two regional cohorts

“…26 Myositis in SLE has been associated with a more active disease, which could explain the association with SDI. 37 In addition, haematological disorder, interstitial lung disease, serositis and aPL (IgG anticardiolipin, anti-β2-glycoprotein-I and LA) were more common among patients with extensive organ damage (Table 3). Possibly, this could reflect the frequent and long-term usage of high doses of corticosteroids in manifestations such as severe cytopenias, serositis and pulmonary involvement where other immunosuppressants occasionally may be insufficient.…”

Metabolic and Structural Skeletal Muscle Health in Systemic Lupus Erythematosus–Related Fatigue: A Multimodal Magnetic Resonance Imaging Study

“…The results are therefore not generalizable to the wider disease spectrum. For example, patients with a history of myositis (prevalent in 4–16% of SLE cases ) were excluded. Data from this study cannot be used to inform the usefulness of these methodologies in the evaluation of such manifestations (a distinct research question).…”