Association of antinuclear antibody status with clinical features and malignancy risk in adult-onset dermatomyositis

Paul M. Hoesly, Jason C. Sluzevich, Anokhi Jambusaria-Pahlajani, Elizabeth R. Lesser, Michael G. Heckman, Andy Abril

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1364-1370
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume80
Issue number5
DOIs
StatePublished - May 1 2019

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Dermatomyositis
Antinuclear Antibodies
Neoplasms
Retrospective Studies
Odds Ratio
Deglutition Disorders
Exanthema

Keywords

  • antinuclear antibody
  • connective tissue disease
  • dermatomyositis
  • inflammatory myopathy
  • malignancy
  • paraneoplastic

ASJC Scopus subject areas

  • Dermatology

Cite this

Association of antinuclear antibody status with clinical features and malignancy risk in adult-onset dermatomyositis. / Hoesly, Paul M.; Sluzevich, Jason C.; Jambusaria-Pahlajani, Anokhi; Lesser, Elizabeth R.; Heckman, Michael G.; Abril, Andy.

In: Journal of the American Academy of Dermatology, Vol. 80, No. 5, 01.05.2019, p. 1364-1370.

Research output: Contribution to journalArticle

Hoesly, Paul M. ; Sluzevich, Jason C. ; Jambusaria-Pahlajani, Anokhi ; Lesser, Elizabeth R. ; Heckman, Michael G. ; Abril, Andy. / Association of antinuclear antibody status with clinical features and malignancy risk in adult-onset dermatomyositis. In: Journal of the American Academy of Dermatology. 2019 ; Vol. 80, No. 5. pp. 1364-1370.
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abstract = "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.",
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AU - Hoesly, Paul M.

AU - Sluzevich, Jason C.

AU - Jambusaria-Pahlajani, Anokhi

AU - Lesser, Elizabeth R.

AU - Heckman, Michael G.

AU - Abril, Andy

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N2 - 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.

AB - 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.

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