Table 1.
Epidemiology | Median age of onset (IQR): | 6.3 (3.8–9.6) years [1] |
Incidence: | 7.98 cases/million/year [2] | |
Prevalence: | 14/100,000 [2] | |
Sex distribution (F:M): | 2.1:1 [3] | |
Clinical features | Muscle weakness | Most patients |
Cutaneous manifestations | 30–70% [3] | |
Calcinosis | 12–47% [4, 5] | |
Lipodystrophy | 8–14% [6] | |
Interstitial lung disease | 8–19% [7] | |
Myocardial involvement | Common, non-specific [8] | |
Vasculopathy | Most patients, central to pathogensis [9] | |
Autoantibodies |
MSA 49% + ve for MSA |
- Transcriptional intermediary factor 1 (TIF-1γ) 22–29% |
- Nuclear matrix protein 2 (NXP2) 23–25% | ||
-Aminoacyl tRNA synthetase (ASA) 2–4% | ||
-Signal recognition particle (SRP) < 2% | ||
−3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) < 1% | ||
-Nucleosome-remodelling deacetylase complex (Mi-2) 4–10% | ||
-Small ubiquitin-like modifier activating enzyme (SAE) < 1% | ||
-Melanoma differentiation associated gene 5 (MDA5) 7–38% [10] | ||
Pathogenesis | Type I IFN signature | Muscle, blood [11, 12] |
Mononuclear cells | Muscle [15] | |
FOXP3+ regulatory T cells | Increased in muscle [16] | |
pDCs | Increased in muscle/skin [17] | |
Myogenic pre-cursor cells | Increased source of IFN in muscle [18, 19] | |
Mast cells | Increased in skin [20] | |
Natural killer cells | Decreased in blood [21] | |
Cytokines | ||
Blood: | Increased IRF-4, IL-6, IL-17F, Il-23A, IL-21, GATA3, IL-1β | |
Muscle: | Increased GATA3, IL-13, STAT5B [22] |