Juvenile dermatomyositis: A retrospective review of a 30-year experience

MDA5 autoantibody—another indicator of clinical diversity in dermatomyositis

“…Some children presenting with CADM have been observed to have their DM skin changes smolder or spontaneously remit with or without symptomatic treatment never having displayed muscle weakness or other systemic complications of classic DM (10,11). In addition, the author has cared for several such children in the past (personal unpublished observation).…”

“…As such, it could be challenging to identify subjects presenting with isolated Hallmark cutaneous manifestations of DM for comparative clinical studies. However, as in adults there is published experience arguing that the prolonged presence of isolated skin manifestations of DM can spontaneously remit in children who might be considered to have CADM with only conservative symptomatic treatment (10,11).…”

Beware of 'normal' creatine kinase levels in HIV-associated polymyositis

“…CK levels are usually raised at least 3-to 4-fold in polymyositis. 3 However, an inflammatory myopathy on muscle biopsy may be associated with a CK level within the normal range, such as in childhood-onset dermatomyositis, 4 inclusion body myositis and even polymyositis, although the latter accounted for <15% of a recent Mayo clinic series. 3 Interestingly, patients with active rheumatoid arthritis without myositis have lower (by half) CK levels than normal controls, although their muscle aldolase levels are higher than controls.…”

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

“…There are a limited number of validated clinical measures to assess activity and damage in the juvenile IIMs, including global muscle strength and physical function measures (2)(3)(4)(5)(6). Such clinical assessments are used with laboratory investigations to assess the inflammatory activity of juvenile IIM (7)(8)(9).…”