Seasonal Effect on Disease Onset and Presentation in Anti-MDA5 Positive Dermatomyositis

Frontiers in Medicine

Victor Tak-Lung Wong¹  Jacqueline So²  Tommy Tsz-On Lam²  Lai-Shan Tam³  Ho So³  Roy Ho⁴  Wai Ling Li⁵  Chak Sing Lau⁶ 

[1] Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong SAR, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong SAR, China;Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China;Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China;Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China;

关键词: anti-MDA5;    dermatomyositis;    idiopathic inflammatory myopathy;    myositis specific antibody;    rapidly progressive interstitial lung disease (RP-ILD);   

DOI  :  10.3389/fmed.2022.837024

来源: DOAJ

【 摘 要 】

ObjectiveTo investigate the seasonal variation of disease onset and presentation in an ethno-geographically homogeneous cohort of patients with anti-MDA5 positive dermatomyositis (DM).MethodsThis was a multi-centered, retrospective cohort study. Adult Chinese anti-MDA5 positive DM patients were identified from the Hong Kong Myositis Registry and the Clinical Data Analysis and Reporting System from 2015 to 2020. Equal number of IIM patients without anti-MDA5 antibody were selected as controls. Line blot immunoassay was used to detect the autoantibodies. The onset of disease, presenting clinical features and subsequent complications were analyzed for any seasonality.ResultsA total of 110 patients with anti-MDA5 positive DM were studied. The mean age at diagnosis was 53.0 ± 12.3 years and the mean follow-up duration was 20.6 ± 23.1 months. Two third of the patients (66%) had the clinically amyopathic phenotype. Most patients (86%) had interstitial lung disease (ILD) and 42% developed rapidly progressive ILD (RP-ILD). The mortality was 40% and the commonest cause was RP-ILD. Chi-square test showed significantly less patients had symptom onset in July to September. However, no particular seasonal pattern was observed in the anti-MDA5 negative IIM controls. RP-ILD occurred more frequently in patients with disease onset in October to December. Anti-MDA5 positive DM patients with disease onset in warmer months (April to September) were more likely to have clinical muscle involvement.ConclusionApparent seasonal patterns were noted in our ethno-geographically identical anti-MDA5 positive DM patients, but not in IIM patients in general. Certain environmental factors, particularly infection, might be implicated.

【 授权许可】

Unknown