AB0221 SEQUENCE OF CLINICAL SYMPTOMS ONSET AND ITS CORRELATION TO THE AUTOANTIBODIES PRESENCE IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES
Authors: Piotr Szczęsny, Anna Felis-Giemza, Katarzyna Swierkocka, Marzena Olesińska
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Idiopathic inflammatory myopathies (IIM) is a heterogeneous group of autoimmune diseases with a broad spectrum of clinical presentations including musculoskeletal, respiratory, neurological, dermatological, gastrointestinal and cardiovascular symptoms. It is known that presence of autoantibodies is a predictor of disease course. However, there is very limited data summarizing long-term observations assessing, when the particular symptoms are expected to occur. <h3>Objectives</h3> To assess the development of the symptoms in IIM patients during the disease course with respect to their serology patterns. <h3>Methods</h3> Medical history of IIM patients treated in our clinic between 2008 and 2019 were reviewed. We excluded patients with: insufficient data for the first period of disease course, history of IIM &lt;6 months, IIM patients who do not fulfill Peter &amp; Bohan 1975 diagnostic criteria (less than 4 points). Finally 103 IIM patients medical history were included for this analysis. EUROLINE test containing 16 myositis specific or associated antibodies (MSAs, MAAs) was used to determine serology for all of those patients. Onsets of symptoms were noted only in case when symptoms were confirmed objectively. Mean time since onset (MTSO) in months was counted for each symptom. <h3>Results</h3> Numbers below are presenting MTSO in months for each symptom. Anti-Jo1 antibodies positive patients (n:30) have presented: rash (0), mechanic hands (1.2), myocarditis (5), muscle weakness (10.3), Raynaud's phenomenon (RP) (10.4), arthritis (20.7), interstitial lung disease (ILD) (23.5), fever (29.1), Gottron's sign (31.3), muscle pain (46.2), dysphagia (53.4). Anti-Mi-2 antibodies positive patients (n:12) have presented: RP (0), mechanic hands (0), rash (0.2), Gottron's sign (0.3), fever (2.5), muscle weakness (4.5), dysphagia (4.5), muscle pain (9), ILD (15.5). Anti-PM-Scl antibodies positive patients (n:7) have presented: rash (1), fever (1), Gottron's sign (1.25), mechanic hands (4), ILD (4), RP (5), arthritis (10.2), muscle weakness (46.3), muscle pain (108.5). Anti-SRP antibodies positive patients (n:5) have presented: muscle weakness, fever, arthritis and ILD symptoms simultaneously (0), then dysphagia (4) and muscle pain (10). Anti-NXP2 antibodies positive patients (n:4) have presented: muscle weakness and pain simultaneously with dysphagia (0), ILD developed 4 months later. Anti-MDA5 antibodies positive patients (n:2) have presented: arthritis (0), fever (0.5), muscle pain (2), rash (3). Anti-Ro52 antibodies positive patients (n:12) have presented: RP (3), Gottron's sign (3.3), rash (3.5), arthritis (5), muscle weakness (6.2), muscle pain (11), myocarditis (11), ILD (12), mechanic hands (13), dysphagia (18.3). MSAs and MAAs negative patients (n:21) have presented: fever (0), RP (0), dysphagia (0,3), muscle pain (0,4), muscle weakness (1.9), rash (20), arthritis (66). <h3>Conclusion</h3> Our study shows differences in disease course in IIM patients with each serology pattern adding new data on chronology of appearances of each symptom, which is important in predicting the future course of the disease and planning long-term management. <h3>References</h3> [1] The Clinical Features of Myositis-Associated Autoantibodies: a Review. Gunawardena H, et al. Clin Rev Allergy Immunol. (2017) [2] Specific autoantibodies in dermatomyositis: a helpful tool to classify different clinical subsets. Merlo, G., Clapasson, A., Cozzani, E. et al. Arch Dermatol Res (2017) 309: 87. <h3>Disclosure of Interests</h3> Piotr Szczęsny: None declared, Anna Felis-Giemza: None declared, Katarzyna Swierkocka: None declared, Marzena Olesińska Consultant for: F. Hoffmann-La Roche