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Contribution of dot-blot assay to the diagnosis and management of myositis: a three-year practice at a university hospital centre

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Department of Internal Medicine, and Department of Immunology, Limoges University Hospital, France.
  2. Department of Internal Medicine, Limoges University Hospital, France.
  3. Department of Internal Medicine, Limoges University Hospital, France.
  4. Department of Neurology, Centre de Référence “Neuropathies Périphériques Rares”, Limoges University Hospital, France.
  5. Department of Neurology, Centre de Référence “Neuropathies Périphériques Rares”, Limoges University Hospital, France.
  6. Department of Internal Medicine, Limoges University Hospital, France.
  7. Department of Internal Medicine, Limoges University Hospital, France.
  8. Department of Internal Medicine, Limoges University Hospital, France.
  9. Department of Internal Medicine, Limoges University Hospital, France.
  10. Department of Internal Medicine, Limoges University Hospital, France.
  11. Department of Internal Medicine, Limoges University Hospital, France.
  12. Department of Immunology, Limoges University Hospital, France.
  13. Department of Internal Medicine, Limoges University Hospital, France. anne-laure.fauchais@unilim.fr

CER9080
2016 Vol.34, N°5
PI 0918, PF 0924
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PMID: 27494325 [PubMed]

Received: 29/10/2015
Accepted : 16/05/2016
In Press: 02/08/2016
Published: 16/09/2016

Abstract

OBJECTIVES:
Idiopathic inflammatory myopathies (IIM) are heterogeneous autoimmune diseases with wide clinical spectrum that may lead to delayed diagnosis. The aim of this study was to examine the impact of IIM-specific dot-blot assay on diagnostic process of patients presenting with muscular or systemic symptoms evocating of IIM.
METHODS:
We collected all the prescriptions of an IIM specific dot-blot assay (8 autoantigens including Jo-1, PL-7, PL-12, SRP, Mi-2, Ku, PM/Scl and Scl-70) over a 38-month period.
RESULTS:
316 myositis dot-blot assays (MSD) were performed in 274 patients (156 women, mean age 53±10.6 years) referring for muscular and/or systemic symptoms suggesting IIM. The timing of dot prescription through the diagnostic process was highly variable: without (35%), concomitantly (16%) or after electromyographic studies (35%). Fifty-nine patients (22%) had IIM according to Bohan and Peter’s criteria. Among them, 29 (49%) had positive dot (8 Jo-1, 6 PM-Scl, 5 PL-12, 5 SRP, 2 Mi-2, 2 PL-7 and 1 Ku). Various other diagnoses were performed including 35 autoimmune disease or granulomatosis (12%), 19 inflammatory rheumatic disease (7%), 16 non inflammatory muscular disorders (6%), 10 drug-induced myalgia (4%), 11 infectious myositis (4%). Except 11 borderline SRP results and one transient PM-Scl, MSD was positive only in one case of IIM. Dot allowed clinicians to correct diagnosis in 4 cases and improved the diagnosis of IIM subtypes in 4 cases.
CONCLUSIONS:
This study reflects the interest of myositis dot in the rapid diagnosis process of patients with non-specific muscular symptoms leading to various diagnoses including IIM.

Rheumatology Article