Background

The clinical significance of antinuclear antibody (ANA) status in adults with dermatomyositis (DM) has yet to be fully defined.

Objective

We compared the incidence of amyopathic disease, risk of malignancy, and clinical findings in ANA⁺ and ANA⁻ patients with adult-onset DM.

Methods

This was a retrospective cohort study of patients with ANA⁺ or ANA⁻ adult-onset DM determined by enzyme-linked immunosorbent assay.

Results

Of 231 patients, 140 (61%) were ANA⁺ and 91 (39%) were ANA^–. Compared with the ANA⁻ patients, the ANA⁺ patients had a lower frequency of dysphagia (15% vs 26% [P = .033]) and heliotrope rash (38% vs 53% [P = .026]). In all, 54 patients (23%) developed malignancy within 3 years of diagnosis of their DM; 11% of the ANA⁺ patients developed malignancy versus 43% of the ANA⁻ patients (P < .001). There was a strong association between ANA positivity and lower likelihood of malignancy in multivariable analysis (odds ratio, 0.16; P < .001). Conversely, ANA positivity was not associated with amyopathic disease (odds ratio, 0.94; P = .87).

Limitations

The retrospective nature of the study was a limitation.

Conclusion

In patients with adult-onset DM, ANA negativity is associated with increased likelihood of development of malignancy within 3 years of diagnosis of their DM. Particularly close follow-up and frequent malignancy screening may be warranted in ANA⁻ individuals with DM.

中文翻译：

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成人成年皮肌炎中抗核抗体状态与临床特征和恶性肿瘤风险的关系

背景

成人患有皮肌炎（DM）的抗核抗体（ANA）状态的临床意义尚未完全确定。

客观的

我们比较了无肌病性疾病，恶性肿瘤的风险，并在ANA临床发现的发病率⁺和ANA ^-患者成人发病DM。

方法

这是患者ANA回顾性队列研究⁺或ANA ^-酶联免疫吸附试验成人发病DM。

结果

在231例患者中，ANA ⁺占140（61％），而ANA ^–占91（39％）。与ANA相比^-的患者，ANA ⁺患者吞咽困难的一个较低的频率（15％比26％[ P  = 0.033]）和天芥菜皮疹（38％比53％[ P  = 0.026]）。在诊断DM的3年内，共有54例患者（占23％）发生了恶性肿瘤。的ANA 11％⁺开发恶性肿瘤相对于ANA的43％的患者^-患者（P  <0.001）。在多变量分析中，ANA阳性与较低恶性肿瘤之间有很强的相关性（优势比为0.16；P <.001）。相反，ANA阳性与肌病无关（优势比为0.94；P  = 0.87）。

局限性

研究的回顾性是一个局限。

结论

在成年DM患者中，ANA阴性与DM诊断后3年内发生恶性肿瘤的可能性增加相关。在ANA ^- DM患者中，可能需要特别密切的随访和频繁的恶性肿瘤筛查。