期刊
ACR OPEN RHEUMATOLOGY
卷 3, 期 5, 页码 287-294出版社
WILEY
DOI: 10.1002/acr2.11247
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资金
- NIAMS NIH HHS [K23AR075898, K23 AR073927, K23 AR075898, P30 AR070254, P30-AR070254] Funding Source: Medline
- Jerome L. Greene Foundation Funding Source: Medline
- Huayi and Siuling Zhang Discovery Fund Funding Source: Medline
- Donald B. and Dorothy L. Stabler Foundation Funding Source: Medline
- Cupid Foundation Funding Source: Medline
This study examines the clinical characteristics of patients with anti-SAE autoantibodies in a North American cohort and investigates cancer prevalence. The performance characteristics of the line blotting method for antibody detection were compared with an immunoprecipitation-based assay.
Objective Antibodies against the small ubiquitin-like modifier (SUMO) activating enzyme (SAE) are one of the rarer specificities associated with dermatomyositis (DM). The purpose of this study is to describe the clinical characteristics of patients with anti-SAE autoantibodies in a North American cohort and to ascertain cancer prevalence. We also describe the performance characteristics of the line blotting (Euroimmun) method for antibody detection compared with an immunoprecipitation-based assay. Methods Sera from 2127 patients suspected of having myositis were assayed for myositis-specific autoantibodies using the Euroimmun platform. Those positive for SAE autoantibodies were assayed by a second method (immunoprecipitation) for confirmation. Only those cases positive by both methods were taken as definite cases of anti-SAE-positive DM. Chart reviews of these patients were completed to obtain information on clinical characteristics, cancer history, and treatment. Results Forty-three of 2127 sera were anti-SAE autoantibody positive by Euroimmun (>= 15 units, +); of these, only 19 were confirmed positive by immunoprecipitation. All 19 cases had skin involvement and varying presentations of muscle, lung, and joint disease. Cancer occurred coincident with DM in two patients, and cancers were detected more than 5 years from symptom onset in three patients. In a population of suspected inflammatory myositis, a higher cutoff on line blot testing (>= 36 units, ++) yielded better agreement with immunoprecipitation methods. Conclusion SAE autoantibodies associate with a clinical phenotype of DM, which most commonly presents with a rash first, followed by muscle involvement and varying extramuscular involvement. As coincident cancer was seen in anti-SAE-positive DM, judicious malignancy screening may be warranted.
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