Dermatomyositis: An Update on Diagnosis and Treatment

Cobos, Gabriela; Femia, Alisa; Vleugels, Ruth Ann

doi:10.1007/s40257-020-00502-6

Cited by 71 publications

(136 citation statements)

References 168 publications

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“…Anti‐TIF‐1γ‐AB‐positive DM is frequently associated with malignancy. This has been demonstrated in a number of studies and is much more common than with other MSAs. One probable reason is that TIF‐1γ is known to be involved in transcription of a tumor suppressor gene (Table ).…”

Section: Myositis‐specific Antibodies (Msa)mentioning

confidence: 68%

“…Statistical surveys have found that about 30 % of DM cases are associated with malignancy [35]. Detection of anti-TIF-1γ AB and anti-NXP-2 Ab, in particular, indicates a high probability of paraneoplastic DM [33,36]; however, tumor screening is recommended for all forms of DM [31]. Clinical signs include skin ulceration, enanthema in the mouth, pronounced skin and muscle symptoms, acute onset of the disease, or involvement of the pharyngeal and diaphragm muscles as well as the distal muscles of the limbs [37,38].…”

Section: Tumor-associated or Paraneoplastic Dmmentioning

confidence: 99%

“…Our current knowledge of MSA does not yet offer a sufficiently firm basis for foregoing extensive tumor screening when certain antibodies are detected [31]. However, the symptoms mentioned above as well as antibodies such as anti-TIF-1γ and anti-NXP-2 must be considered as important warning signs.…”

Section: Tumor-associated or Paraneoplastic Dmmentioning

confidence: 99%

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Update on dermatomyositis in adults

Schlecht

Sunderkötter

Niehaus

et al. 2020

J Deutsche Derma Gesell

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Dermatomyositis (DM) in adults has a prevalence of 6-7 per 100,000 population per year. This dedicated compact overview was prepared due to an increasing incidence as well as an often underestimated systemic involvement and new developments in myositis-specific antibodies (MSA). The spectrum of clinical dermatological and systemic symptoms is described. Related diagnostic procedures are depicted, and therapeutic regimens based on the German S2k guidelines and the current literature are presented. The urgency of an early diagnosis is emphasized as about 30 % of patients with DM manifest a tumor. Etiopathology is often associated with pulmonary fibrosis, and inflammation of myositis can cause irreversible muscle damage. Clinical signs and correct interpretation of serological markers can deliver valuable information on the extent of DM, and provide an indication for further diagnostic procedures, prognosis and choice of therapy.

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Section: Myositis‐specific Antibodies (Msa)mentioning

confidence: 68%

Section: Tumor-associated or Paraneoplastic Dmmentioning

confidence: 99%

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Update on dermatomyositis in adults

Schlecht

Sunderkötter

Niehaus

et al. 2020

J Deutsche Derma Gesell

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“…Dermatomyositis (DM) is a rare chronic autoimmune disease primarily affecting skeletal muscle and the skin, with characteristic cutaneous findings and varying amounts of systemic involvement [1]. It is still a poorly understood multisystem disease.…”

Section: Introductionmentioning

confidence: 99%

Next-generation sequencing technology for detecting pulmonary fungal infection in bronchoalveolar lavage fluid of a patient with dermatomyositis: a case report and literature review

Zhang

Chen

et al. 2020

BMC Infect Dis

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Background: Invasive fungal pneumonia is a severe infectious disease with high mortality in immunocompromised patients. However, the clinical diagnosis of the pathogen(s) remains difficult since microbiological evidence is difficult to acquire. Case presentation: Here, we report a case of pulmonary fungal infection detected by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) in a 61-year-old male with corticosteroid-treated dermatomyositis. Cytomegalovirus and influenza A virus infections were confirmed by nucleic acid detection and treated with antiviral medicine. The patient had been diagnosed with severe pneumonia and treated with empiric broad-spectrum antibacterial and antifungal drugs before bronchoscopy was performed. The patient responded poorly to those empiric treatments. Three fungi were found by NGS in the BALF, namely, Pneumocystis jirovecii, Aspergillus fumigatus and Rhizopus oryzae. After adjusting the patient's treatment plan according to the NGS results, he improved significantly. Conclusions: This case highlights the combined application of NGS and traditional tests in the clinical diagnosis of pulmonary invasive fungal disease. NGS is proposed as an important adjunctive diagnostic approach for identifying uncommon pathogens.

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“…It is now recognized that DM is associated with an intriguing diversity of myositis-specific autoantibodies (MSAs) that often have characteristic associated systemic and cutaneous manifestations (10)(11)(12)(13)(14)(15)(16)(17). These MSAs define subclasses of disease with each autoantibody having characteristic clinical associations, organ pathology, HLA associations, and microRNA profiles (18)(19)(20)(21)(22).…”

Section: E R M a T O M Y O S I T I S ( D M ) I S O N E O F T H E I D I O P A T H I C Inflammatory Myopathies (Iims) Whose Classification mentioning

confidence: 99%

Dermatomyositis autoantibodies: how can we maximize utility?

Hodgkinson¹,

Wu²,

Fiorentino³

2021

Ann Transl Med

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The past 15 years has seen significant advances in the characterization of myositis-specific autoantibodies (MSAs) and their associated phenotypes in patients with dermatomyositis (DM). As more careful studies are performed, it is clear that unique combinations of clinical and pathological phenotypes are associated with each MSA, despite the fact that there is considerable heterogeneity within antibody classes as well as overlap across the groups. Because risk for interstitial lung disease (ILD), internal malignancy, adverse disease trajectory, and, potentially response to therapy differ by DM MSA group, a deeper understanding of MSAs and validation and standardization of assays used for detection are critical for optimizing diagnosis and treatment. Like any test, the diagnostic sensitivity and specificity of assays for various MSAs is not perfect. Currently tests for MSAs are helpful at minimum for a clinician to assess relative risk or contribute to diagnosis and perhaps counsel the appropriate patient about what to expect.With international standardization and larger studies it is likely that more antibody tests will make their way into formal schemata for diagnosis and actionable risk assessment in DM. In this review, we summarize key considerations for interpreting the clinical and pathologic associations with MSA in DM and identify critical gaps in knowledge and practice that will maximize their clinical utility and utility for understanding disease pathogenesis.

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Dermatomyositis: An Update on Diagnosis and Treatment

Cited by 71 publications

References 168 publications

Update on dermatomyositis in adults

Update on dermatomyositis in adults

Next-generation sequencing technology for detecting pulmonary fungal infection in bronchoalveolar lavage fluid of a patient with dermatomyositis: a case report and literature review

Dermatomyositis autoantibodies: how can we maximize utility?

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