Clinical characteristics and prognostic analysis of idiopathic
inflammatory myopathy with positive anti-aminoacyl-tRNA synthetase
antibodies
Abstract
To determine distinct phenotype groups in patients with idiopathic
inflammatory myopathy (IIM), and to identify the differences of clinical
characteristics, laboratory findings, and the long-term outcomes in
patients with antisynthetase syndrome (ASS) of different
anti-aminoacyl-tRNA synthetase (ARS) antibodies. Methods: We enrolled
retrospectively 280 patients with IIM, and the clinical characteristics
and laboratory findings were collected. Additionally, multivariate COX
regression analysis was performed to identify indicators of poor
prognosis in patients with ASS. Results: 119 ASS and 161 non-ASS
patients were identified in 280 patients with IIM, the occurrence rates
of ILD, RP-ILD, pulmonary symptoms, arthritis, triad and mechanic’s
hands with ASS group were more prevalent than non-ASS group ( p<0.05).
Among 119 patients with ASS, the highest incidence of RP-ILD occurred in
the PL12 group (36.4%). There was clinical significance of statistical
differences in arthritis, myositis, mechanic’s hands, triad, shawl sign,
v sign, and Raynaud’s phenomenon among the 4 subgroups ( p<0.05). At
the same time, the individuals in the positive anti-Jo1 antibody group
were more likely to exhibit arthritis, myositis, mechanic’s hands, triad
and, v sign than the negative anti-Jo1 antibody group in patients with
ASS, furthermore, statistically more prevalent ( p<0.05). According to
the multivariate COX regression analysis, mechanic’s hands, ANA, and ILD
were independent risk factors for poor prognosis in patients with ASS (
p<0.001, p=0.026, and p<0.001, respectively). V sign
was an independent protective factor for good prognosis in patients with
ASS ( p=0.026). Conclusions: When clinical characteristics including
pulmonary symptoms, arthritis, mechanic’s hands, ANA, along with ILD
appear, clinicians should be on the alert for the occurrence of ASS in
patients with IIM