The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis

Chinoy, Hector; Fertig, Noreen; Oddis, Chester V.; Ollier, William; Cooper, Robert G.

doi:10.1136/ard.2006.068502

Cited by 310 publications

(224 citation statements)

References 23 publications

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“…It was demonstrated that antigenic myositis-specific autoantigens are expressed in both tumor cells and myoblasts, and then myositis-specific autoantigen is expressed in an initial tumor leading to the generation of both specific T and B cells targeting those antigens, and subsequently stimulate immune responses previously generated in the anti-tumor response. [12][13][14][15] These may explain the mechanism of the coexistence of DM and cancer.…”

Section: Discussionmentioning

confidence: 99%

“…16 Thus, the determination of clinical and laboratory signs for association with malignancy are of great importance for the disease prognosis. In some studies, relatively high proportions of anti-155/140 antibodies were detected in cancer-associated DM patients, and these have an excellent positive predictive value 12,13,17 Therefore, introduction of a commercial kit for this antibody to be applied in clinical screening may be beneficial. It was also shown that anti-Jo-1 antibody and cancer-associated DM, or interstitial lung disease and cancerassociated DM appear mutually exclusive.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory analysis showed an increased white blood cell count of 20x10 9 L (NR 4-10x10 9 /L), decreased red blood cell count of 1.28x10 12 /L (NR 3.5-5.0x10…”

Section: Case Reportmentioning

confidence: 99%

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Metachronous Basal Cell Carcinoma and Primary Plasmacytic Leukemia Associated With Dermatomyositis

2014

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Dermatomyositis (DM) is an autoimmune inflammatory disease characterized by the association of progressive proximal muscle weakness and specific cutaneous signs, as well as multisystemic manifestations.1 Although the association between DM and elevated risks of comorbid cancers has been studied extensively, 2 individuals with multiple malignancies associated with DM are rare. Some previous reports associated DM and two different types of malignancies in the same individual. [3][4][5] To the best of our knowledge, this is the first case of the metachronous basal-cell carcinoma of the nasolabial fold and plasma cell leukemia occurring in the same DM patient over a period of time. CASE REPORTA 71-year-old female patient presented with a four-month history of muscle weakness, such as difficulty in raising her hands over the level of her shoulders and walking up and down the stairs. Physical examination revealed periorbital violaceous erythema and Gottron's papules on both elbows. Strength testing demonstrated a grade of 3/5 for the cervical muscle, upper and lower limbs. Laboratory tests showed elevated muscle enzymes with a creatine phosphokinase

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Metachronous Basal Cell Carcinoma and Primary Plasmacytic Leukemia Associated With Dermatomyositis

2014

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“…The additional use of MTX showed significantly improved treatment efficacy. A previous study by Chinoy et al examined the risk of cancer-associated myositis (25). They showed that the detection of anti-Ku antibody in myositis is associated with a lower frequency of cancer as well as a favorable prognosis.…”

Section: Discussionmentioning

confidence: 99%

Sarcoid Myositis with Anti-Ku Antibody Consistent with both Sarcoidosis and Polymyositis

et al. 2016

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We herein describe a case of sarcoid myositis with anti-Ku antibody positivity. Pathological findings of the muscle were compatible with sarcoidosis, but could not be completely distinguished from myositis diseases that arise from other causes. According to a physical examination, pathological findings, the detection of antiKu antibody and the human leukocyte antigen (HLA)-DPB1 allele, we strongly suspected that the patient developed both sarcoidosis and polymyositis. Sarcoidosis is often complicated by autoimmune diseases. This case suggests the possibility that sarcoidosis and other autoimmune diseases may have common causal genetic factors.

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“…According to a recent meta-analysis, factors associated with a paraneoplastic etiology of myositis include advanced age, male gender, skin necrosis, and dysphagia [104]. Detection of anti-155/140-Abs in cases with negative classical Abs (anti-Jo-1, anti-PM-Scl, anti-U1-RNP, anti-U3-RNP, anti-Ku) is in 94 % associated with a paraneoplastic origin [105]. While anti-synthetase-Abs are typically associated with autoimmune etiology, their detection does not reliably rule out a paraneoplastic origin of the disease [106].…”

Section: Paraneoplastic Myositismentioning

confidence: 99%

Management of Immune-Mediated Paraneoplastic Neurological Disorders

Ayzenberg

Gold

Kleiter

2017

Neurology International Open

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AbsTR Ac TParaneoplastic neurological disorders are rare and clinically heterogeneous diseases. They can affect both the central and peripheral nervous system as well as the neuromuscular junction and muscle. Neurological deficits develop in 2/3 of cases prior to cancer diagnosis. The diagnostic approach includes screening for antineuronal antibodies and a search for the underlying tumor. A prompt tumor therapy in combination with immunotherapy is the cornerstone in the management of these diseases. Due to lack of clinical trials, treatment recommendations are based on case series and expert opinions. Highdose corticosteroids, intravenous immunoglobulins and apheresis therapies are often used in the acute stage of the disease. These therapies should be started as early as possible, e. g., during tumor screening, in order to prevent irreversible damage. Long-term treatment is mostly immunosuppressive and depends on the specific paraneoplastic syndrome. Outcomes vary depending upon the prognosis of the underlying cancer and the nature of the antineuronal antibodies. Disorders with antibodies directed against antigens on the neuronal cell surface are highly sensitive to B cell-directed therapies and mostly associated with a favorable outcome. A thorough review of published data on actual treatment recommendation is provided along with discussion of currently not validated, but potentially effective new therapies. E264Ayzenberg I et al. Management of Immune-mediated Paraneoplastic … Neurology International Open 2017; 1: E264-E274 course, treatment response and prognosis of PNS [2,3]. Depending on tumor association, obligate and facultative paraneoplastic Abs are differentiated (Tab. 1).Clinically, the following PNS exist [3,4]: A. In the central nervous system: ▪ Encephalomyelitis (incl. brainstem encephalitis) ▪ Limbic encephalitis ▪ Subacute cerebellar degeneration ▪ Opsoclonus-myoclonus syndrome ▪ Optic neuritis/neuromyelitis optica ▪ Myelopathy/myelitis ▪ Stiff person syndrome ▶Table 1 Paraneoplastic antibodies: associated neurological syndromes and tumors. Target antigen clinical presentation# Association with tumorObligate paraneoplastic Abs (directed against intracellular antigens; tumor association > 95 %) In this review we discuss the diagnosis and management of PNS. With regard to facultative paraneoplastic syndromes which are more frequently of autoimmune origin, such as neuromyelitis optica or myasthenia gravis, the reader should refer to pertinent reviews [5,6]. Diagnostic and Pathogenetic Significance of Antibodies to Intracellular and Surface AntigensAntibodies (Abs) to intracellular antigens or so-called "classical" Abs are almost always tumor-associated (exception: GAD-Abs). They can be associated with various tumors and a variety of neurological conditions [7]. However, a direct pathogenetic significance of these Abs has not yet been demonstrated. Abs to intracellular antigens serve as useful diagnostic markers in the targeted tumor search in PNS. Here, cell-mediated immune responses play a major p...

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The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis

Cited by 310 publications

References 23 publications

Metachronous Basal Cell Carcinoma and Primary Plasmacytic Leukemia Associated With Dermatomyositis

Metachronous Basal Cell Carcinoma and Primary Plasmacytic Leukemia Associated With Dermatomyositis

Sarcoid Myositis with Anti-Ku Antibody Consistent with both Sarcoidosis and Polymyositis

Management of Immune-Mediated Paraneoplastic Neurological Disorders

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