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Characterising oesophageal motility disorders by high-resolution impedance manometry in dermatomyositis patients


1, 2, 3, 4, 5, 6, 7, 8, 9

 

  1. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Unit, P. Giaccone University Hospital, University of Palermo, Italy.
  2. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Unit, P. Giaccone University Hospital, University of Palermo, Italy.
  3. Department of General Emergency and Transplant Surgery, General and Emergency Surgery Unit, Oesophageal Motility Disorder Section, P. Giaccone University Hospital, University of Palermo, Italy.
  4. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Unit, P. Giaccone University Hospital, University of Palermo, Italy.
  5. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Unit, P. Giaccone University Hospital, University of Palermo, Italy.
  6. Department of General Emergency and Transplant Surgery, General and Emergency Surgery Unit, Oesophageal Motility Disorder Section, P. Giaccone University Hospital, University of Palermo, Italy.
  7. Department of General Emergency and Transplant Surgery, General and Emergency Surgery Unit, Oesophageal Motility Disorder Section, P. Giaccone University Hospital, University of Palermo, Italy.
  8. Department of General Emergency and Transplant Surgery, General and Emergency Surgery Unit, Oesophageal Motility Disorder Section, P. Giaccone University Hospital, University of Palermo, Italy.
  9. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Unit, P. Giaccone University Hospital, University of Palermo, Italy. giuliana.guggino@gmail.com

CER16832
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PMID: 37812480 [PubMed]

Received: 14/05/2023
Accepted : 24/07/2023
In Press: 19/09/2023

Abstract

OBJECTIVES:
We studied high-resolution impedance manometry (HRiM) findings in dermatomyositis (DM) to detect oesophageal dysmotility, even in asymptomatic patients, and correlated the alterations to clinical and serological disease domains.
METHODS:
We performed a cross-sectional study of DM patients, enrolled between December 2021 and December 2022. All patients underwent rheumatological, laboratory and HRiM assessment. HRiM findings were compared with different clinical and serological profiles.
RESULTS:
The study population consisted of 15 DM patients (13 women and 2 men, age 54±15.2 years). The mean disease duration was 6.6 years. According to HRiM findings, three different groups of oesophageal disease severity were identified (in order of severity G0, G1 and G>1, 5 patients per group). G>1 group was significantly associated with MDA5 antibodies (80% vs. 20%, p<0.05). Interstitial lung disease (ILD) did not show any significant association with HRiM findings. However, a diffusing lung capacity for carbon oxide (DLCO) < 80% was present in 100% of G>1 (p<0.05). No associations between dysphagia, creatine kinase (CK) level, muscle weakness, skin, articular involvement and treatment were found.
CONCLUSIONS:
Oesophageal involvement is frequent and should be evaluated in the comprehensive work-up of DM. We used for the first time HRiM in DM, which proved to be an accurate and objective technique in assessing oesophageal disease, even in the subclinical stage. Interestingly, the MDA5-positive group had a higher burden of HRiM pathological findings, suggesting a greater severity of oesophageal involvement, often asymptomatic.

DOI: https://doi.org/10.55563/clinexprheumatol/h4drr2

Rheumatology Article