Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study

Huang, Yi-Hsiang; Chen, Y.J.; Lin, Ming; Wu, Changjing; Liu, P.C.; Chen, T.J.; Chen, Y.C.; Jih, Jaw Shyang; Chen, C.C.; Lee, D.D.; Chang, Yun Ting; Wang, W.J.; Liu, H.N.

doi:10.1111/j.1365-2133.2009.09274.x

Cited by 98 publications

(91 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Malignancy was found after the diagnosis of DM in only 1 patient. This contrasts somewhat with previous studies 32,33 reporting that the diagnosis of DM is made before the development of malignancy in at least half of patients. Regarding patients with anti-155/140 Abs, Chinoy et al 34 reported that malignancy preceded the onset of DM in only 1 of 8 patients.…”

Section: Commentcontrasting

confidence: 96%

Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis

Hamaguchi¹,

Kuwana²,

Hoshino³

et al. 2011

Arch Dermatol

306

258

View full text Add to dashboard Cite

show abstract

Section: Commentcontrasting

confidence: 96%

Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis

Hamaguchi¹,

Kuwana²,

Hoshino³

et al. 2011

Arch Dermatol

306

258

View full text Add to dashboard Cite

show abstract

“…In studies carried out in Western countries, Hill et al [15], Sigurgeirsson et al [2] and others reported lung, colon and rectum cancer to be the most frequent malignancies. Chen et al reported that nasopharyngeal carcinoma, one of the most common neoplasmas in the Taiwanese population, was also the most frequent among Taiwanese patients with inflammatory myopathies [16][17][18]. These results suggest that the type and site of malignancy in patients with inflammatory myopathies parallels the expected probability of that cancer in each ethnic or regional population.…”

Section: Discussionmentioning

confidence: 92%

Incidence and predictive factors for malignancies in 136 Japanese patients with dermatomyositis, polymyositis and clinically amyopathic dermatomyositis

et al. 2010

View full text Add to dashboard Cite

The aim of this study was to define the standardized incidence ratio (SIR) of malignancy and the potential risk factors of concomitant malignancies in patients with inflammatory myopathies, including clinically amyopathic dermatomyositis (CADM). A total of 145 patients diagnosed with either dermatomyositis/polymyositis (DM/PM) or CADM at our institute between 1984 and 2002 were enrolled in the study. The demographic, clinical and laboratory features of the patients at the time of DM/PM or CADM diagnosis were compared between patients with and without malignancies, respectively. Multivariate analysis by logistic regression was used to determine the independent risk factors for the development of malignancies in DM/PM patients. Malignancy was found in 17 of 70 patients with DM (24%), three of 15 patients with CADM (20%), and three of 51 patients with PM (6%). Gastric cancer (8/23) was the most common malignancy. Compared with general population, the SIR of malignancies was 13.8 (range 9.0-21.1). The patients who developed malignancies were older (61.5 vs. 51.1 years; P < 0.005), presented more often with dysphagia (61 vs. 15%; P < 0.0001) and were less likely to have the complication of interstitial lung disease (30 vs. 60%; P < 0.05). These features were independent predictive factors for developing malignancies in multiple logistic regression analysis. The results of our study confirm that CADM in addition to DM was associated with high rates of malignancy among our patient cohort.

show abstract

“…7,9,20 Patients with anti-MDA5-positive-DM have a malignancy risk similar to the general dermatomyositis population (3-6 fold increased risk compared to the general population), and thus should undergo age-appropriate workup for malignancy, including screening for nasopharyngeal carcinoma in patients of Asian descent. 7,14,[21][22][23][24] Treatment of anti-MDA5-positive-DM consists of potent immunosuppressive therapy, especially in the presence of underlying rapidly progressive ILD. 14 This patient had an unusual presentation of dermatomyositis, and several diagnostic errors contributed to a delay in his diagnosis (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Anti-MDA5-Positive Dermatomyositis Presenting as Fever of Unknown Origin

et al. 2016

View full text Add to dashboard Cite

Dermatomyositis is a chronic systemic autoimmune disease characterized by inflammatory infiltrates in the skin and muscle. The wide variability in clinical and serologic presentation poses a diagnostic challenge for the internist. Appreciation of the clinical variants of dermatomyositis allows for expedient diagnosis and avoidance of diagnostic error. We illustrate these challenges with the case of a 51-year-old VietnameseAmerican man who initially presented with fever of unknown origin in the absence of overt skin and muscle manifestations. The diagnosis of dermatomyositis was not evident on several clinical encounters due to the absence of these hallmark symptoms. We review the variable clinical manifestations of a subtype of dermatomyositis associated with an autoantibody against melanoma differentiation-associated protein 5 (anti-MDA5) and suggest consideration of dermatomyositis as a diagnosis in patients presenting with systemic illness and markedly elevated ferritin, even in the absence of elevated muscle enzymes and classic autoantibodies. CASE PRESENTATIONA 51-year-old Vietnamese-American male industrial engineer was admitted to the medical ward for evaluation of fever of unknown origin (FUO). He reported 3 weeks of fever, fatigue, generalized weakness, and dyspnea. His past medical history included a remote 10-pack-year history of cigarette smoking and latent tuberculosis treated with 9 months of isoniazid treatment, completed 5 years prior. He had moved from Vietnam to the United States 30 years earlier and denied any recent travel, sick contacts, or insect bites. Physical examination revealed a fatigued man, with a temperature of 38.1°C, pulse of 108 beats/minute, respiratory rate of 28 breaths/minute, and room air oxygen saturation of 96 %. Oropharyngeal, neurologic, pulmonary, cardiac, musculoskeletal, and skin evaluation were otherwise normal.A complete blood count (CBC) revealed anemia (hemoglobin 12.3 g/dL, hematocrit 38.5 %). White blood cell counts, platelet counts, and the basic metabolic panel were normal. Erythrocyte sedimentation rate (ESR) was 97 mm/hr and C-reactive protein (CRP) was 5.7 mg/dL. Muscle enzymes, sent to evaluate his weakness in the setting of elevated inflammatory markers, showed normal creatine kinase (CK) at 44 units/liter and mildly elevated aldolase to 9.4 U/L (normal: < 7.7 U/L). Blood, urine, and sputum cultures had no growth. Chest x-ray (CXR) demonstrated low lung volumes with increased reticular markings, small bilateral pleural effusions, and bibasilar opacities. During the hospitalization, he continued to have intermittent fevers as high as 39.1°C, generalized weakness, and dyspnea. Additionally, he developed bibasilar crackles on pulmonary exam and flat, diffuse, slightly hyperpigmented patches on his arms and chest that faded over several days. Extensive workup for infectious, inflammatory, and malignant causes of fever was unrevealing, including negative viral hepatitis serologies, human immunodeficiency virus antibody, anti-nuclear antibody (ANA), and anti-...

show abstract

Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study

Abstract: This is the first large-scale study to report the associated malignancies and the cancer risk of IIM in Taiwan.

Cited by 98 publications

References 31 publications

Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis

Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis

Incidence and predictive factors for malignancies in 136 Japanese patients with dermatomyositis, polymyositis and clinically amyopathic dermatomyositis

Anti-MDA5-Positive Dermatomyositis Presenting as Fever of Unknown Origin

Contact Info

Product

Resources

About