Departmental Bulletin Paper Articular manifestations in Japanese patients with polymyositis and dermatomyositis

Takao, Nagashima  ,  Takamasa, Murosaki  ,  Kyoko, Honne  ,  Yasuyuki, Kamata  ,  Katsuya, Nagatani  ,  Masahiro, Iwamoto  ,  Seiji, Minota1

Objective: To investigate the association between joint symptoms and related conditions in Japanese patientswith polymyositis( PM) and dermatomyositis( DM).Methods: We retrospectively reviewed all patients with PM/DM who were admitted to our departmentfrom January 2007 to March 2012. Clinical data on these patients were retrieved from the medical records.Results: Seventy-eight patients (20 with PM and 58 with DM) were enrolled. Among them, 37 patients(47%)had arthralgia or arthritis. Joint symptoms were more frequent in DM than PM (53% vs. 30%,P=0.07). Anti-aminoacyl tRNA antibodies (ASA) were positive in 25 patients (32%), and anti-cyclic citrullinatedpeptide (CCP)antibody was positive in 7 patients (9%). Patients with anti-Jo-1 antibody had a highfrequency of polyarthritis( 82%), while anti-CCP antibody was positive in 4 out of 11 patients with anti-Jo-1antibody (36%). Among patients with joint symptoms, anti-Jo-1 antibody was positive in 67% of the patientswith PM, but was positive in only 16% of the patients with DM. Four of the 78 patients (5%) were initiallydiagnosed and treated as having rheumatoid arthritis. Multivariate analysis showed that fever, Raynaud’sphenomenon, and anti-Jo-1 antibody were associated with joint symptoms, whereas overall ASA positivityshowed no significant difference between patients with or without joint symptoms.Conclusion: Forty-seven percent of patients with PM/DM had joint symptoms. Except for anti-Jo-1 antibody,ASA were not associated with joint symptoms in Japanese PM/DM patients.

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