Concomitant diseases in a cohort of patients with idiopathic myositis during long-term follow-up

Clinical Rheumatology, 04/30/2009

Ng KP et al. - Study reports a significant steroid-related morbidity in adult idiopathic inflammatory myositis (IIM) patients under long-term follow-up. The prevalence of another concomitant auto-immune disease unlike patients with lupus or Sjogren's syndrome is low.

Methods

  • Aim was to report the concomitant diseases observed and damage outcome in pts with adult IIM during long-term f/u
  • Pts identified between 1979 and 2006 that fulfilled at least 3/4 of Bohan and Peter criteria
  • Patients excluded:
    • with inclusion body myositis
    • juvenile-onset myositis and
    • overt overlap syndromes
  • Medical notes were retrospectively reviewed
  • Concomitant diseases identified were divided into 12 different organ systems:
    • bone, cardiac, respiratory, gastrointestinal,
    • renal, central nervous, malignancy, infection,
    • endocrine, eyes, dermatological and haematological
  • Patient damage index was calculated using the Myositis Damage Index tool

Results

  • 55 pts (31 polymyositis, 24 dermatomyositis) were identified
  • Most prevalent organ system involved was lung with 40 events per 1,000 patient yrs f/u
  • There was steroid-related complications with 17/18 pts with bone involvement having osteopenia/osteoporosis
  • Sjogren's syndrome (n=3) was the most frequent concomitant auto-immune disease observed
  • Pts with a higher number of organ systems involved had a higher damage index
  • White pts showed a trend to develop >3 other organ system involvement and myositis-related lung disease vs other races

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