Necrotizing myopathy: Clinicoserologic associations

• Published in: Muscle & nerve Vol. 45; no. 2; pp. 189 - 194
• Main Authors: Ellis, Elizabeth, Ann Tan, Ju, Lester, Sue, Tucker, Graeme, Blumbergs, Peter, Roberts-Thomson, Peter, Limaye, Vidya
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-02-2012; Wiley
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; anti-SRP autoantibodies; Arterial hypertension. Arterial hypotension; Autoantibodies - blood; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Creatine Kinase, MM Form - blood; Diabetes Mellitus - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Experimental diseases; Female; Humans; Hypertension - epidemiology; idiopathic inflammatory myopathy; Lupus Erythematosus, Systemic - epidemiology; Male; Medical sciences; Middle Aged; Myositis - blood; Myositis - epidemiology; Myositis - immunology; myositis-associated antibodies; necrotizing myopathy; Online Systems; South Australia - epidemiology; systemic lupus erythematosus; Young Adult; South Australia; Endocrinopathy; Autoimmunity; Skin disease; Autoimmune disease; Cardiovascular disease; idiopathic inflammatory myopathy; Pain; Systemic lupus erythematosus; myositis-associated antibodies; Systemic disease; necrotizing myopathy; Human; Hypertension; Immunopathology; Connective tissue disease; anti-SRP autoantibodies; Diabetes mellitus; Idiopathic; Autoantibody; Myalgia; Malignant tumor; Striated muscle disease; Myositis; Cancer; Myopathy
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.22279

Introduction: Necrotizing myopathy (NM) is distinguished from idiopathic inflammatory myositis (IIM) by dominance of myofiber necrosis, lack of mononuclear inflammatory infiltrates, and presence of antibodies to signal recognition particle (SRP). Methods: The clinical features of 64 cases of NM were determined. Measurement of autoantibodies was undertaken on stored sera from 23 patients with NM. The incidence of malignancy was determined from the South Australian Cancer Registry. Results: NM patients showed male predominance (61%), more frequent myalgias, and higher creatine kinase (CK) levels compared with IIM patients. Patients with NM had a high incidence of systemic lupus erythematosus (SLE) (21%), hypertension (11 of 17, 65%), and diabetes mellitus (3 of 13, 23%). No patient had antibodies to SRP. NM patients showed no altered risk for malignancy compared with the South Australian population (P = 0.86). Conclusions: NM is associated with SLE, hypertension, and diabetes mellitus. Comprehensive assessment of cardiovascular risk is indicated in NM, which raises the possibility of targeted interventions. Muscle Nerve, 2012