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Erschienen in: Clinical Rheumatology 12/2010

01.12.2010 | Original Article

Clinical characteristics and outcomes of patients with idiopathic inflammatory myopathies from Jordan 1996–2009

verfasst von: Khader N. Mustafa, Said S. Dahbour

Erschienen in: Clinical Rheumatology | Ausgabe 12/2010

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Abstract

To describe demographic characteristics, clinical features and outcome of Jordanian patients with idiopathic inflammatory myopathies (IIM), a retrospective chart review of all patients diagnosed with IIM at Jordan University Hospital between 1996 and 2009 was carried out. Thirty patients with IIM were identified. Female to male ratio was 1.7:1, with mean age at diagnosis 34.3 ± 9.2 (10–72) years with bimodal presentation at 21 and 49 years and a mean follow-up of 6.5 ± 5.7 years. Eleven patients had polymyositis (PM); 19 patients had dermatomyositis (DM); 1 patient had DM with malignancy; 2 patients had juvenile DM; and 2 patients had DM/PM with other rheumatologic diseases. Raynaud's phenomenon was present in 26% of patients, dysphagia in 40%, fever in 16%, arthralgia/arthritis in 26%, and dyspnea was present in 26% patients. Positive muscle biopsy and EMG were present in 81% and 92% of patients, respectively. Elevated serum creatinine kinase (CK), AST/ALT and LDH were found in 90%, 72%, and 88% of patients at presentation, respectively. Interstitial fibrosis identified on high-resolution computed tomography (HRCT) was found in 7/14 (50%) patients. Restrictive lung disease was present in 16/21 (76%), low diffusion capacity of lung of carbon monoxide (DLCO) in 10/17 (59%) and pulmonary hypertension in only 3/19 (16%) patients tested. Arab Jordanian patients with IIM showed very low prevalence of malignancy, lower mean age than previous reports, and similar other clinical, laboratory and serologic markers, and survival rate to previous reports. Of interest, we found that extra-muscular manifestations were mainly associated with dermatomyositis.
Literatur
1.
Zurück zum Zitat Dalakas MC (1991) Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med 325:1487–1498CrossRefPubMed Dalakas MC (1991) Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med 325:1487–1498CrossRefPubMed
2.
Zurück zum Zitat Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347CrossRefPubMed Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347CrossRefPubMed
3.
Zurück zum Zitat Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407CrossRefPubMed Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407CrossRefPubMed
4.
Zurück zum Zitat Al-Ballaa ST, Al-Dalaan AN, El-Ramahi KM et al (1993) Pattern of adult onset of polymyositis and dermatomyositis and association with malignancy. Ann Saudi Med 13:525–529PubMed Al-Ballaa ST, Al-Dalaan AN, El-Ramahi KM et al (1993) Pattern of adult onset of polymyositis and dermatomyositis and association with malignancy. Ann Saudi Med 13:525–529PubMed
5.
Zurück zum Zitat Lynn SJ, Sawyers SM, Moller PW et al (2005) Adult-onset inflammatory myopathy: north Canterbury experience 1989–2001. Intern Med J 35:170–173CrossRefPubMed Lynn SJ, Sawyers SM, Moller PW et al (2005) Adult-onset inflammatory myopathy: north Canterbury experience 1989–2001. Intern Med J 35:170–173CrossRefPubMed
6.
Zurück zum Zitat Ramirez G, Asherson RA, Khamashta MA et al (1990) Adult-onset polymyositis-dermatomyositis: description of 25 patients with emphasis on treatment. Semin Arthritis Rheum 20:114–120CrossRefPubMed Ramirez G, Asherson RA, Khamashta MA et al (1990) Adult-onset polymyositis-dermatomyositis: description of 25 patients with emphasis on treatment. Semin Arthritis Rheum 20:114–120CrossRefPubMed
7.
Zurück zum Zitat Holden DJ, Brownell AK, Fritzler MJ (1985) Clinical and serologic features of patients with polymyositis or dermatomyositis. Can Med Assoc J 132:649–653PubMed Holden DJ, Brownell AK, Fritzler MJ (1985) Clinical and serologic features of patients with polymyositis or dermatomyositis. Can Med Assoc J 132:649–653PubMed
8.
Zurück zum Zitat Uthman I, Vazquez-Abad D, Senecal JL (1996) Distinctive features of idiopathic inflammatory myopathies in French Canadians. Semin Arthritis Rheum 26:447–458CrossRefPubMed Uthman I, Vazquez-Abad D, Senecal JL (1996) Distinctive features of idiopathic inflammatory myopathies in French Canadians. Semin Arthritis Rheum 26:447–458CrossRefPubMed
9.
Zurück zum Zitat Benbassat J, Gefel D, Larholt K et al (1985) Prognostic factors in polymyositis/dermatomyositis: a computer assisted analysis of ninety-two cases. Arthritis Rheum 28:249–255CrossRefPubMed Benbassat J, Gefel D, Larholt K et al (1985) Prognostic factors in polymyositis/dermatomyositis: a computer assisted analysis of ninety-two cases. Arthritis Rheum 28:249–255CrossRefPubMed
10.
Zurück zum Zitat Hochberg MC, Feldman D, Stevens MB (1986) Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. Semin Arthritis Rheum 15:168–178CrossRefPubMed Hochberg MC, Feldman D, Stevens MB (1986) Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. Semin Arthritis Rheum 15:168–178CrossRefPubMed
11.
Zurück zum Zitat Koh ET, Seow A, Ong B et al (1993) Adult onset polymyositis/dermatomyositis: clinical and laboratory features and treatment response in 75 patients. Ann Rheum Dis 52:857–861CrossRefPubMed Koh ET, Seow A, Ong B et al (1993) Adult onset polymyositis/dermatomyositis: clinical and laboratory features and treatment response in 75 patients. Ann Rheum Dis 52:857–861CrossRefPubMed
12.
Zurück zum Zitat Ríos G (2005) Retrospective review of the clinical manifestations and outcomes in Puerto Ricans with idiopathic inflammatory myopathies. J Clin Rheumatol 11:153–156CrossRefPubMed Ríos G (2005) Retrospective review of the clinical manifestations and outcomes in Puerto Ricans with idiopathic inflammatory myopathies. J Clin Rheumatol 11:153–156CrossRefPubMed
13.
Zurück zum Zitat Dorph C, Nennesmo I, Lundberg IE (2001) Percutaneous conchotome muscle biopsy. A useful diagnostic and assessment tool. J Rheumatol 28:1591–1599PubMed Dorph C, Nennesmo I, Lundberg IE (2001) Percutaneous conchotome muscle biopsy. A useful diagnostic and assessment tool. J Rheumatol 28:1591–1599PubMed
14.
Zurück zum Zitat Sultan SM, Ioannou Y, Moss K et al (2002) Outcome in patients with idiopathic inflammatory myositis; morbidity and mortality. Rheumatology 41:22–26CrossRefPubMed Sultan SM, Ioannou Y, Moss K et al (2002) Outcome in patients with idiopathic inflammatory myositis; morbidity and mortality. Rheumatology 41:22–26CrossRefPubMed
15.
Zurück zum Zitat Bohan A, Peter JB, Bowman RL et al (1977) A computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 56:255–286 Bohan A, Peter JB, Bowman RL et al (1977) A computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 56:255–286
16.
Zurück zum Zitat Chen IJ, Jan Wu YJ, Lin CW et al (2009) Interstitial lung disease in polymyositis and dermatomyositis. Clin Rheumatol 28:639–646CrossRefPubMed Chen IJ, Jan Wu YJ, Lin CW et al (2009) Interstitial lung disease in polymyositis and dermatomyositis. Clin Rheumatol 28:639–646CrossRefPubMed
17.
Zurück zum Zitat Marie I, Hachulla E, Cherin P et al (2002) Interstitial lung disease in polymyositis and dermatomyositis. Arthritis Rheum 47:614–622CrossRefPubMed Marie I, Hachulla E, Cherin P et al (2002) Interstitial lung disease in polymyositis and dermatomyositis. Arthritis Rheum 47:614–622CrossRefPubMed
18.
Zurück zum Zitat Schnabel A, Reuter M, Biederer J et al (2003) Interstitial lung disease in polymyositis and dermatomyositis: clinical course and response to treatment. Semin Arthritis Rheum 32:273–284CrossRefPubMed Schnabel A, Reuter M, Biederer J et al (2003) Interstitial lung disease in polymyositis and dermatomyositis: clinical course and response to treatment. Semin Arthritis Rheum 32:273–284CrossRefPubMed
19.
Zurück zum Zitat Marie I, Harton PY, Hachulla E et al (1998) Pulmonary involvement in polymyositis and in dermatomyositis. J Rheumatol 25:1336–1343PubMed Marie I, Harton PY, Hachulla E et al (1998) Pulmonary involvement in polymyositis and in dermatomyositis. J Rheumatol 25:1336–1343PubMed
20.
Zurück zum Zitat Kang EH, Lee EB, Shin KC et al (2005) Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology 44:1282–1286CrossRefPubMed Kang EH, Lee EB, Shin KC et al (2005) Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology 44:1282–1286CrossRefPubMed
21.
Zurück zum Zitat Hirakata M, Nakamura K, Kaburaki J et al (1995) Interstitial lung disease in patients with connective tissue diseases. Jpn J Thorac Dis 33(Suppl):268–276 Hirakata M, Nakamura K, Kaburaki J et al (1995) Interstitial lung disease in patients with connective tissue diseases. Jpn J Thorac Dis 33(Suppl):268–276
22.
Zurück zum Zitat Fathi M, Vikgren J, Boijsen M et al (2008) Interstitial lung disease in polymyositis and dermatomyositis: longitudinal evaluation by pulmonary function and radiology. Arthritis Rheum 59:677–685CrossRefPubMed Fathi M, Vikgren J, Boijsen M et al (2008) Interstitial lung disease in polymyositis and dermatomyositis: longitudinal evaluation by pulmonary function and radiology. Arthritis Rheum 59:677–685CrossRefPubMed
23.
Zurück zum Zitat Lakhanpal S, Lie JT, Conn DL et al (1987) Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases. Ann Rheum Dis 46:23–29CrossRefPubMed Lakhanpal S, Lie JT, Conn DL et al (1987) Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases. Ann Rheum Dis 46:23–29CrossRefPubMed
24.
Zurück zum Zitat Epler GR, McLoud TC, Gaensler EA et al (1978) Normal chest roentgenograms in chronic diffuse infiltrative lung disease. N Engl J Med 298:934–939CrossRefPubMed Epler GR, McLoud TC, Gaensler EA et al (1978) Normal chest roentgenograms in chronic diffuse infiltrative lung disease. N Engl J Med 298:934–939CrossRefPubMed
25.
Zurück zum Zitat Danko K, Ponyi A, Constantin T et al (2004) Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine 83:35–42CrossRefPubMed Danko K, Ponyi A, Constantin T et al (2004) Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine 83:35–42CrossRefPubMed
26.
Zurück zum Zitat Maugars YM, Berthelot JM, Abbas AA et al (1996) Long-term prognosis of 69 patients with dermatomyositis or polymyositis. Clin Exp Rheumatol 14:263–274PubMed Maugars YM, Berthelot JM, Abbas AA et al (1996) Long-term prognosis of 69 patients with dermatomyositis or polymyositis. Clin Exp Rheumatol 14:263–274PubMed
27.
Zurück zum Zitat Marie I, Hachulla E, Hatron PY et al (2001) Polymyositis and dermatomyositis: short term and longterm outcome, and predictive factors of prognosis. J Rheumatol 28:2230–2237PubMed Marie I, Hachulla E, Hatron PY et al (2001) Polymyositis and dermatomyositis: short term and longterm outcome, and predictive factors of prognosis. J Rheumatol 28:2230–2237PubMed
28.
Zurück zum Zitat Torres C, Belmonte R, Carmona L et al (2006) Survival, mortality and causes of death in inflammatory myopathies. Autoimmunity 39:205–215CrossRefPubMed Torres C, Belmonte R, Carmona L et al (2006) Survival, mortality and causes of death in inflammatory myopathies. Autoimmunity 39:205–215CrossRefPubMed
29.
Zurück zum Zitat Porkodi R, Shanmuganandan K, Parthiban M et al (2002) Clinical spectrum of inflammatory myositis in South India—a ten year study. J Assoc Physicians India 50:1255–1258PubMed Porkodi R, Shanmuganandan K, Parthiban M et al (2002) Clinical spectrum of inflammatory myositis in South India—a ten year study. J Assoc Physicians India 50:1255–1258PubMed
30.
Zurück zum Zitat Stockton D, Doherty VR, Brewster DH (2001) Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study. Br J Cancer 85:41–45CrossRefPubMed Stockton D, Doherty VR, Brewster DH (2001) Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study. Br J Cancer 85:41–45CrossRefPubMed
31.
Zurück zum Zitat Buchbinder R, Forbes A, Hall S et al (2001) Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study. Ann Intern Med 134:1087–1095PubMed Buchbinder R, Forbes A, Hall S et al (2001) Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study. Ann Intern Med 134:1087–1095PubMed
32.
Zurück zum Zitat Sigurgeirsson B, Lindelöf B, Edhag O et al (1992) Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med 326:363–367CrossRefPubMed Sigurgeirsson B, Lindelöf B, Edhag O et al (1992) Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med 326:363–367CrossRefPubMed
33.
Zurück zum Zitat Zhang W, Jiang SP, Huang L (2009) Dermatomyositis and malignancy: a retrospective study of 115 cases. Eur Rev Med Pharmacol Sci 13:77–80PubMed Zhang W, Jiang SP, Huang L (2009) Dermatomyositis and malignancy: a retrospective study of 115 cases. Eur Rev Med Pharmacol Sci 13:77–80PubMed
34.
Zurück zum Zitat András C, Ponyi A, Constantin T et al (2008) Dermatomyositis and polymyositis associated with malignancy: a 21-year retrospective study. J Rheumatol 35:438–444PubMed András C, Ponyi A, Constantin T et al (2008) Dermatomyositis and polymyositis associated with malignancy: a 21-year retrospective study. J Rheumatol 35:438–444PubMed
35.
Zurück zum Zitat Lee SW, Jung SY, Park MC (2006) Malignancies in Korean patients with inflammatory myopathy. Yonsei Med J 31(47):519–523CrossRef Lee SW, Jung SY, Park MC (2006) Malignancies in Korean patients with inflammatory myopathy. Yonsei Med J 31(47):519–523CrossRef
36.
Zurück zum Zitat Ponyi A, Constantin T, Garami M et al (2005) Cancer-associated myositis: clinical features and prognostic signs. Ann N Y Acad Sci 1051:64–71CrossRefPubMed Ponyi A, Constantin T, Garami M et al (2005) Cancer-associated myositis: clinical features and prognostic signs. Ann N Y Acad Sci 1051:64–71CrossRefPubMed
37.
Zurück zum Zitat Maoz CR, Langevitz P, Livneh A et al (1998) High incidence of malignancies in patients with dermatomyositis and polymyositis: an 11-year analysis. Semin Arthritis Rheum 27:319–324CrossRefPubMed Maoz CR, Langevitz P, Livneh A et al (1998) High incidence of malignancies in patients with dermatomyositis and polymyositis: an 11-year analysis. Semin Arthritis Rheum 27:319–324CrossRefPubMed
38.
Zurück zum Zitat Manchul LA, Jin A, Pritchard KI et al (1985) The frequency of malignant neoplasms in patients with polymyositis–dermatomyositis. A controlled study. Arch Intern Med 145:1835–1839CrossRefPubMed Manchul LA, Jin A, Pritchard KI et al (1985) The frequency of malignant neoplasms in patients with polymyositis–dermatomyositis. A controlled study. Arch Intern Med 145:1835–1839CrossRefPubMed
39.
Zurück zum Zitat Hill CL, Zhang Y, Sigurgeirsson B et al (2001) Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet 357:96–100CrossRefPubMed Hill CL, Zhang Y, Sigurgeirsson B et al (2001) Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet 357:96–100CrossRefPubMed
40.
Zurück zum Zitat Airio A, Pukkala E, Isomäki H (1995) Elevated cancer incidence in patients with dermatomyositis: a population based study. J Rheumatol 22:1300–1303PubMed Airio A, Pukkala E, Isomäki H (1995) Elevated cancer incidence in patients with dermatomyositis: a population based study. J Rheumatol 22:1300–1303PubMed
41.
Zurück zum Zitat Antiochos BB, Brown LA, Li Z et al (2009) Malignancy is associated with dermatomyositis but not polymyositis in Northern New England, USA. J Rheumatol 36:2704–2710CrossRefPubMed Antiochos BB, Brown LA, Li Z et al (2009) Malignancy is associated with dermatomyositis but not polymyositis in Northern New England, USA. J Rheumatol 36:2704–2710CrossRefPubMed
42.
Zurück zum Zitat Toumi S, Ghnaya H, Braham A et al (2009) Polymyositis and dermatomyositis in adults. Tunisian multicentre study. Rev Med Interne 30:747–753CrossRefPubMed Toumi S, Ghnaya H, Braham A et al (2009) Polymyositis and dermatomyositis in adults. Tunisian multicentre study. Rev Med Interne 30:747–753CrossRefPubMed
Metadaten
Titel
Clinical characteristics and outcomes of patients with idiopathic inflammatory myopathies from Jordan 1996–2009
verfasst von
Khader N. Mustafa
Said S. Dahbour
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 12/2010
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-010-1465-8

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