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. 1993 Dec;52(12):857–861. doi: 10.1136/ard.52.12.857

Adult onset polymyositis/dermatomyositis: clinical and laboratory features and treatment response in 75 patients.

E T Koh 1, A Seow 1, B Ong 1, P Ratnagopal 1, H Tjia 1, H H Chng 1
PMCID: PMC1005215  PMID: 8311535

Abstract

OBJECTIVES--To determine possible similarities and differences in clinical and laboratory features and treatment response between patients in Singapore with polymyositis (PM) and dermatomyositis (DM) and reported series. METHODS--Case records of adult patients (16 years old and above) referred to the 3 main electromyographic (EMG) laboratories in Singapore between 1 June 1986 and 31 May 1991 were reviewed if the referring diagnosis was myositis or myopathy for investigation. A computer search for adult patients with a diagnosis of PM/DM (ICD codes 710.3, 710.4, 517.8) who attended the main rheumatology and neurology centre during this period was also carried out. The criteria for PM/DM proposed by Bohan and Peter was adopted. RESULTS--The incidence of PM/DM was 7.7 cases per million population per year. There were 35 PM and 40 DM cases with a median age at diagnosis of 50.7 years (SD: 16.7) and significantly more females in the PM group (p < 0.05). At presentation, 86.7% had proximal myopathy, 34.7% had arthralgia/arthritis and 18.7% had cutaneous vasculitis. The creatine kinase level was elevated in 89.3% of patients and positive EMG and muscle biopsy in 79.4% and 76.4% respectively. Systemic lupus erythematosus was the commonest associated connective tissue disease. The percentage of patients with malignancy was higher in DM compared with PM (p < 0.01) and they were significantly older (mean age 61.8 years) (p < 0.001). Patients who achieved remission were significantly younger (mean age 46.4 years, p < 0.05). The overall mortality rate was 26.7% with infection and malignancy as the main causes of death. CONCLUSION--The results of the study suggest ethnicity does not influence the expression of PM/DM in view of the considerable similarities in frequency and clinical expression of disease in the population studied compared with series from other countries.

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Selected References

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  1. Arsura E. L., Greenberg A. S. Adverse impact of interstitial pulmonary fibrosis on prognosis in polymyositis and dermatomyositis. Semin Arthritis Rheum. 1988 Aug;18(1):29–37. doi: 10.1016/0049-0172(88)90032-7. [DOI] [PubMed] [Google Scholar]
  2. Basset-Seguin N., Roujeau J. C., Gherardi R., Guillaume J. C., Revuz J., Touraine R. Prognostic factors and predictive signs of malignancy in adult dermatomyositis. A study of 32 cases. Arch Dermatol. 1990 May;126(5):633–637. [PubMed] [Google Scholar]
  3. Behan W. M., Behan P. O., Gairns J. Cardiac damage in polymyositis associated with antibodies to tissue ribonucleoproteins. Br Heart J. 1987 Feb;57(2):176–180. doi: 10.1136/hrt.57.2.176. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Benbassat J., Gefel D., Larholt K., Sukenik S., Morgenstern V., Zlotnick A. Prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninety-two cases. Arthritis Rheum. 1985 Mar;28(3):249–255. doi: 10.1002/art.1780280303. [DOI] [PubMed] [Google Scholar]
  5. Bohan A., Peter J. B., Bowman R. L., Pearson C. M. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 1977 Jul;56(4):255–286. doi: 10.1097/00005792-197707000-00001. [DOI] [PubMed] [Google Scholar]
  6. Bohan A., Peter J. B. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975 Feb 13;292(7):344–347. doi: 10.1056/NEJM197502132920706. [DOI] [PubMed] [Google Scholar]
  7. Chan H. L. Dermatomyositis and cancer in Singapore. Int J Dermatol. 1985 Sep;24(7):447–450. doi: 10.1111/j.1365-4362.1985.tb05816.x. [DOI] [PubMed] [Google Scholar]
  8. Cox N. H., Lawrence C. M., Langtry J. A., Ive F. A. Dermatomyositis. Disease associations and an evaluation of screening investigations for malignancy. Arch Dermatol. 1990 Jan;126(1):61–65. doi: 10.1001/archderm.126.1.61. [DOI] [PubMed] [Google Scholar]
  9. DeVere R., Bradley W. G. Polymyositis: its presentation, morbidity and mortality. Brain. 1975 Dec;98(4):637–666. doi: 10.1093/brain/98.4.637. [DOI] [PubMed] [Google Scholar]
  10. Feldman D., Hochberg M. C., Zizic T. M., Stevens M. B. Cutaneous vasculitis in adult polymyositis/dermatomyositis. J Rheumatol. 1983 Feb;10(1):85–89. [PubMed] [Google Scholar]
  11. Fudman E. J., Schnitzer T. J. Dermatomyositis without creatine kinase elevation. A poor prognostic sign. Am J Med. 1986 Feb;80(2):329–332. doi: 10.1016/0002-9343(86)90036-7. [DOI] [PubMed] [Google Scholar]
  12. Henriksson K. G., Sandstedt P. Polymyositis--treatment and prognosis. A study of 107 patients. Acta Neurol Scand. 1982 Apr;65(4):280–300. doi: 10.1111/j.1600-0404.1982.tb03087.x. [DOI] [PubMed] [Google Scholar]
  13. Hochberg M. C., Feldman D., Stevens M. B. Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. Semin Arthritis Rheum. 1986 Feb;15(3):168–178. doi: 10.1016/0049-0172(86)90014-4. [DOI] [PubMed] [Google Scholar]
  14. Hochberg M. C., Lopez-Acuna D., Gittelsohn A. M. Mortality from polymyositis and dermatomyositis in the United States, 1968-1978. Arthritis Rheum. 1983 Dec;26(12):1465–1471. doi: 10.1002/art.1780261208. [DOI] [PubMed] [Google Scholar]
  15. Lakhanpal S., Bunch T. W., Ilstrup D. M., Melton L. J., 3rd Polymyositis-dermatomyositis and malignant lesions: does an association exist? Mayo Clin Proc. 1986 Aug;61(8):645–653. doi: 10.1016/s0025-6196(12)62030-8. [DOI] [PubMed] [Google Scholar]
  16. Manchul L. A., Jin A., Pritchard K. I., Tenenbaum J., Boyd N. F., Lee P., Germanson T., Gordon D. A. The frequency of malignant neoplasms in patients with polymyositis-dermatomyositis. A controlled study. Arch Intern Med. 1985 Oct;145(10):1835–1839. [PubMed] [Google Scholar]
  17. Medsger T. A., Jr, Dawson W. N., Jr, Masi A. T. The epidemiology of polymyositis. Am J Med. 1970 Jun;48(6):715–723. doi: 10.1016/s0002-9343(70)80006-7. [DOI] [PubMed] [Google Scholar]
  18. Medsger T. A., Jr, Robinson H., Masi A. T. Factors affecting survivorship in polymyositis. A life-table study of 124 patients. Arthritis Rheum. 1971 Mar-Apr;14(2):249–258. doi: 10.1002/art.1780140210. [DOI] [PubMed] [Google Scholar]
  19. Ogle S. Retrospective study of polymyositis in Auckland over 10 years. N Z Med J. 1980 Dec 10;92(673):433–435. [PubMed] [Google Scholar]
  20. PEARSON C. M. PATTERNS OF POLYMYOSITIS AND THEIR RESPONSES TO TREATMENT. Ann Intern Med. 1963 Dec;59:827–838. doi: 10.7326/0003-4819-59-6-827. [DOI] [PubMed] [Google Scholar]
  21. Plotz P. H., Dalakas M., Leff R. L., Love L. A., Miller F. W., Cronin M. E. Current concepts in the idiopathic inflammatory myopathies: polymyositis, dermatomyositis, and related disorders. Ann Intern Med. 1989 Jul 15;111(2):143–157. doi: 10.7326/0003-4819-111-2-143. [DOI] [PubMed] [Google Scholar]
  22. Ramírez G., Asherson R. A., Khamashta M. A., Cervera R., D'Cruz D., Hughes G. R. Adult-onset polymyositis-dermatomyositis: description of 25 patients with emphasis on treatment. Semin Arthritis Rheum. 1990 Oct;20(2):114–120. doi: 10.1016/0049-0172(90)90024-a. [DOI] [PubMed] [Google Scholar]
  23. Rose A. L., Walton J. N. Polymyositis: a survey of 89 cases with particular reference to treatment and prognosis. Brain. 1966 Dec;89(4):747–768. doi: 10.1093/brain/89.4.747. [DOI] [PubMed] [Google Scholar]
  24. Sigurgeirsson B., Lindelöf B., Edhag O., Allander E. Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med. 1992 Feb 6;326(6):363–367. doi: 10.1056/NEJM199202063260602. [DOI] [PubMed] [Google Scholar]
  25. Songcharoen S., Raju S. F., Pennebaker J. B. Interstitial lung disease in polymyositis and dermatomyositis. J Rheumatol. 1980 May-Jun;7(3):353–360. [PubMed] [Google Scholar]
  26. Tymms K. E., Webb J. Dermatopolymyositis and other connective tissue diseases: a review of 105 cases. J Rheumatol. 1985 Dec;12(6):1140–1148. [PubMed] [Google Scholar]
  27. Wong K. O. Dermatomyositis: a clinical investigation of twenty-three cases in Hong Kong. Br J Dermatol. 1969 Jul;81(7):544–547. doi: 10.1111/j.1365-2133.1969.tb16031.x. [DOI] [PubMed] [Google Scholar]

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