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Predictive value of myositis antibodies: role of semiquantitative classification and positivity for more than one autoantibody.
RMD Open
January 2025
TYKS laboratories, Clinical Microbiology, Turku University Hospital, Turku, Finland.
Objectives: We assessed the positive predictive value (PPV) of 17 myositis antibodies for having a diagnosis of myositis and other myositis-spectrum conditions (interstitial lung disease (ILD), connective tissue diseases (CTD), malignancy) and evaluated the impact of semiquantitative classification and antibody overlap on the PPVs.
Materials And Methods: We retrospectively identified 1068 individuals ≥18 years who tested positive for ≥1 antibody in the EUROLINE myositis line blot assay or positive for anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) in an ELISA-based test between 2015 and 2020 in 15 out of the 20 hospital districts in Finland. We extracted clinical diagnoses from the Care Register for Health Care between January 2013 and June 2022.
Applicability of a serodiagnostic line blot for idiopathic inflammatory myopathy: the muscle biopsy is not all.
Front Neurol
January 2025
Neurosciences and Clinical Department, Centro Universitário ABC, Santo André, Brazil.
Introduction: Differential diagnosis of rare idiopathic inflammatory myopathies (IIM) is mainly based on clinical aspects, muscle biopsy analysis, and auxiliary assays that determine myositis-specific and associated autoantibodies (MSA and MAA). While MSAs are considered specific for their respective IIM subclass, MAAs can be present in more than one subclass and in other conditions. This study compares results of a multispecific line blot assay with the final diagnosis of IIM patients based on clinical features and muscle biopsy to draw conclusions for the test's applicability in the diagnostic workflow.
View Article and Find Full Text PDFTherapeutic plasmapheresis as an effective treatment for refractory anti-3-hydroxy-3-methylglutaryl coenzyme A reductase-positive immune-mediated necrotising myopathy.
BMJ Case Rep
January 2025
Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Immune-mediated necrotising myopathy (IMNM) can be associated with autoantibodies to 3-hydroxy-3-methylglutaryl coenzyme A reductase (anti-HMGCR). We present a case of a man in his 60s with a 13-year history of relapsing anti-HMGCR-positive IMNM, intermittently partially responsive to various treatments including corticosteroids, methotrexate, mycophenolate, intravenous immunoglobulin, abatacept and rituximab. After a repeat presentation with severe weakness, plasmapheresis was commenced, resulting in rapid and significant improvement in muscle strength and biochemical markers, which was sustained for several months.
View Article and Find Full Text PDFCase report: Rapid clinical improvement of anti-HMGCR immune-mediated necrotizing myopathy treated with efgartigimod.
Front Immunol
November 2024
Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Immune-mediated necrotizing myopathy (IMNM) with anti-HMGCR antibody positivity is characterized by proximal extremity weakness, increased creatine kinase, and extensive muscle edema. There is an urgent need to find more appropriate treatment options for anti-HMGCR IMNM patients who do not respond well to conventional therapy in the acute phase. With the advent of targeted biologics, new treatment options are available.
View Article and Find Full Text PDF[Not Available].
Ugeskr Laeger
October 2024
Afdeling for Hjertesygdomme, Sygehus Sønderjylland, Aabenraa.
Statin-induced immune-mediated necrotising myopathy (IMNM) is a rare complication associated with statin use. IMNM is classified as one of the inflammatory myopathies characterised by myalgia and elevated serum creatine kinase (CK) levels. In this case report, we present a 58-year-old woman who developed IMNM secondary to atorvastatin use.
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