Cancer-associated myositis: an elusive entity

Fayyaz, Beenish; Rehman, Hafiz J.; Uqdah, Hakim

doi:10.1080/20009666.2019.1571880

Cited by 12 publications

(9 citation statements)

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“…The exact mechanism of this relationship between cancer and dermatomyositis has yet to be elucidated. The term cancer‐associated myositis has been proposed as a paraneoplastic syndrome 21 . High‐risk features associated with cancer‐associated myositis include old age, dermatomyositis, absence of interstitial lung disease, severe cutaneous necrotizing inflammation on biopsy, poor response to myositis treatment, 21 and dysphagia 22 .…”

Section: Discussionmentioning

confidence: 99%

“…The term cancer‐associated myositis has been proposed as a paraneoplastic syndrome 21 . High‐risk features associated with cancer‐associated myositis include old age, dermatomyositis, absence of interstitial lung disease, severe cutaneous necrotizing inflammation on biopsy, poor response to myositis treatment, 21 and dysphagia 22 . The most suggestive risk of cancer in myositis is associated with autoantibodies anti‐TIF1‐gamma and antinuclear matrix protein‐2 22 .…”

Section: Discussionmentioning

confidence: 99%

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An itchy rash and muscle weakness

Risavi

Puller

Juhasz

2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An itchy rash and muscle weakness

Risavi

Puller

Juhasz

2021

Clinical Case Reports

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“…A recent review defines cancer-associated myopathy (CAM) as myopathy that occurs two years before or three years after the diagnosis of cancer [ 48 ]. There are four possible forms of myositis described: dermatomyositis (DM), polymyositis (PM), necrotizing myopathy (NM), and inclusion body myositis (IBM).…”

Section: Discussionmentioning

confidence: 99%

“…CAM is resistant to standard treatment but usually improves after treating the underlying neoplasia; additionally, recurrence of cancer has been associated with relapse of CAM [ 61 ]. Due to the high incidence of cancer during the first three years of myositis, annual cancer surveillance must be emphasized for the first three to four years [ 48 , 62 ]. Recommended surveillance is a complete pelvic/prostate examination, chest radiography, and age and gender-appropriate cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Dilemma of Paraneoplastic Rheumatic Disorders: Case Series and Narrative Review

Cho¹,

Anderson²,

Guevara³

et al. 2021

Cureus

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Paraneoplastic rheumatic disorder (RD) is a disorder that may present before, concurrent with, or after the diagnosis of malignancy. Paraneoplastic RDs are a clinical expression of occult cancer that is not directly related to a tumor or metastasis and manifests as rheumatoid symptoms. The RD is determined by the organ system affected by articular, muscular, cutaneous, vascular, or miscellaneous symptoms. Each case is challenging to diagnose because cancer may present with similar symptoms as a common rheumatic disorder. Of note, the majority of cases have minimal responsiveness or no responsiveness to standard rheumatoid treatment. Therefore, it is imperative to recognize and treat the underlying cancer accordingly. Herein, we present four different diagnostic dilemma cases of RD: case #1 -leukocytoclastic vasculitis and C3 glomerulopathy, case #2 -scleroderma, case #3 -Raynaud's syndrome and possible lupus-like syndrome, and case #4 -inflammatory myositis. Institutional IRB approval was obtained for this case series. We will discuss and review the literature on each topic. In addition, we will mention a review of paraneoplastic rheumatoid arthritis. As rheumatic disease is associated with the use of immune checkpoint inhibitors (ICIs) for cancer treatment, we will briefly discuss some of the most common rheumatic presentations in the setting of these drugs. This case review aims to inform clinicians about the atypical presentation of paraneoplastic RD and to highlight the need for interdisciplinary management between rheumatologists, oncologists, and primary care practitioners.

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“…1 Multiple epidemiological studies have reported an association between inflammatory myopathies and cancer, strongly linked with DM. [2][3][4] It has been demonstrated that even 1/3 of patients with DM may present malignancy in the 3 years after DM diagnosis. An exact explanation for this relationship remains unknown, although it may be related to altered cellular and humoral immunity.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of idiopathic inflammatory myopathies with novel myositis-specific autoantibodies

Rams¹,

Kosałka-Węgiel²,

Kuszmiersz³

et al. 2021

Adv Clin Exp Med

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Background. In recent years, many novel myositis-specific autoantibodies (MSAs) have been identified. However, their links with the pathogenesis and clinical manifestations of inflammatory myopathies remain uncertain. Objectives.To characterize the population of adult dermatomyositis (DM) and polymyositis (PM) patients treated at our center for autoimmune diseases using clinical and laboratory measures. Materials and methods.According to the Bohan and Peter criteria, we retrospectively analyzed patients who fulfilled diagnostic criteria for DM or PM. Myositis-specific autoantibodies and myositis-associated autoantibodies (MAAs) were identified using immunoblot assays.Results. Fifty-one PM (71% women) and 36 DM (67% women) Caucasian patients with a median age of 58 (range: 21-88) years who met the definite or probable diagnostic criteria for myositis were included in the study. Myositis-specific autoantibodies were identified in 63 (72%) patients, whereas MAAs were observed in 43 (49%) of them. Interstitial lung disease (ILD) was characteristic of PM patients (67%, χ 2 with Yates's correction (χ c 2 ) = 13.8078, df = 1, p = 0.0002), being associated with anti-Jo-1 or anti-PL-12 antibodies (fraction comparison test (FCT) 6.4878, p < 0.0001, 6.8354, p = 0.0003, respectively). Interestingly, among patients with anti-MDA5 antibodies (n = 8, 9.2%), all but one had an amyopathic form, with more frequent ILD, skin changes and arthralgias than observed in other patients (FCT 4.7029, p = 0.0228 and p = 7.7986, p = 0.0357, p = 4.7029 and p = 0.0228, respectively). Anti-signal recognition particle (SRP) was strongly associated with the Raynaud's phenomenon (FCT 4. 1144, p = 0.0289) and the highest muscle injury markers (Mann-Whitney U test, z = 2.5293, p = 0.0114). Malignancy was recorded in 14 (16%) patients and was equally common in those with PM and DM. The anti-TIF-1γ was the most frequently related to cancer χ 2 = 14.7691, df = 1, p < 0.0001). The anti-Mi-2α, similarly prevalent in DM and PM, was typically accompanied by skin changes (FCT 7.7986, p = 0.0357) but not ILD (FCT 8.7339, p = 0.0026). Conclusions.Identification of MSAs might help to predict the clinical course of the autoimmune myopathy and malignancy risk. However, these antibodies were absent in about 30% of patients with typical PM or DM manifestations, which encourages further research in this area.

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Cancer-associated myositis: an elusive entity

Cited by 12 publications

References 11 publications

An itchy rash and muscle weakness

An itchy rash and muscle weakness

Diagnostic Dilemma of Paraneoplastic Rheumatic Disorders: Case Series and Narrative Review

Characteristics of idiopathic inflammatory myopathies with novel myositis-specific autoantibodies

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