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Distinctive features of idiopathic inflammatory myopathies inFrench Canadians

Identifieur interne : 001957 ( Istex/Corpus ); précédent : 001956; suivant : 001958

Distinctive features of idiopathic inflammatory myopathies inFrench Canadians

Auteurs : Imad Uthman ; Dolores Vázquez-Abad ; Jean-Luc Senécal

Source :

RBID : ISTEX:FCBE24EA2E321AF32083816E03DDDA554FFB1FF9

English descriptors

Abstract

Abstract: This is the first report on idiopathic inflammatory myopathies (IIM) in FrenchCanadians. We reviewed retrospectively 30 French Canadian adults (20 women and 10 men) with IIM seen consecutively over 12 years. The median age at diagnosis was 45 years. The IIM were 8 (27%) primary polymyositis (PM), 9 (30%) primary dermatomyositis (DM), 5 (17%) IIM with neoplasia (lymphoma, breast, esophageal, colonic, and skin cancer) and 8 (27%) IIM with a connective tissue disease (4 with systemic sclerosis, 2 with mixed connective tissue disease, and 2 with rheumatoid arthritis). The most common presenting symptom was proximal muscle weakness (n = 10,33%). Of the remaining 20 patients, 6 (20%) had the onset of their weakness within 1 month of the presenting symptom. Only 3 (10%) patients did not have proximal muscle weakness. Twenty-six (87%) patients had weakness in the pelvic girdle, 25 (83%) in the shoulder girdle, and 7 (23%) in the neck muscles. Other common symptoms included dyspnea on exertion and dysphagia, each present in 13 (43%) patients. Gottron's papules and the heliotrope rash were the most common skin lesions documented in 11 (37%) and 10 (33%) patients, respectively. The serum creatine kinase (CK) level was between 171 and 1,000 U/L in 13 (43%) patients and between 1,001 and 6,000 U/L in 13 (43%) patients. Antinuclear antibodies (ANA) on HEp-2 cells were positive in 16 (53%) patients, of which 2 (13%) expressed autoantibodies to nuclear pore complexes. Autoantibody specificities were anti-La (n = 4,13%), anti-U1RNP (n = 3,10%), and anti-Ro (n = 2,7%). None of the patients expressed anti-Jo-1, anti-topoisomerase I, or anticentromere antibodies. Twenty-eight (93%) patients received corticosteroid therapy, and 8 (27%) patients responded to prednisone alone. Thirteen (43%) patients were treated with methotrexate, and 9 (69%) responded. The mean follow-up was 62 months: 23 (77%) had their disease controlled, 3 (10%) patients were lost to follow-up, and 4 (13%) died (no death occurred because of IIM or its treatment). Therapy was discontinued because of remission in 5 (17%) patients. Cumulative survival rates at 2, 5, and 10 years were 89%, 89%, and 85%, respectively. The presence of autoantibodies to nuclear pore complexes and anti-La autoantibodies, the rare occurrence of anti-Jo-1, autoantibodies, the response to conventional therapies, and a high survival rate may distinguish IIM in French Canadians from that of other reported series.

Url:
DOI: 10.1016/S0049-0172(96)80025-4

Links to Exploration step

ISTEX:FCBE24EA2E321AF32083816E03DDDA554FFB1FF9

Le document en format XML

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<div type="abstract" xml:lang="en">Abstract: This is the first report on idiopathic inflammatory myopathies (IIM) in FrenchCanadians. We reviewed retrospectively 30 French Canadian adults (20 women and 10 men) with IIM seen consecutively over 12 years. The median age at diagnosis was 45 years. The IIM were 8 (27%) primary polymyositis (PM), 9 (30%) primary dermatomyositis (DM), 5 (17%) IIM with neoplasia (lymphoma, breast, esophageal, colonic, and skin cancer) and 8 (27%) IIM with a connective tissue disease (4 with systemic sclerosis, 2 with mixed connective tissue disease, and 2 with rheumatoid arthritis). The most common presenting symptom was proximal muscle weakness (n = 10,33%). Of the remaining 20 patients, 6 (20%) had the onset of their weakness within 1 month of the presenting symptom. Only 3 (10%) patients did not have proximal muscle weakness. Twenty-six (87%) patients had weakness in the pelvic girdle, 25 (83%) in the shoulder girdle, and 7 (23%) in the neck muscles. Other common symptoms included dyspnea on exertion and dysphagia, each present in 13 (43%) patients. Gottron's papules and the heliotrope rash were the most common skin lesions documented in 11 (37%) and 10 (33%) patients, respectively. The serum creatine kinase (CK) level was between 171 and 1,000 U/L in 13 (43%) patients and between 1,001 and 6,000 U/L in 13 (43%) patients. Antinuclear antibodies (ANA) on HEp-2 cells were positive in 16 (53%) patients, of which 2 (13%) expressed autoantibodies to nuclear pore complexes. Autoantibody specificities were anti-La (n = 4,13%), anti-U1RNP (n = 3,10%), and anti-Ro (n = 2,7%). None of the patients expressed anti-Jo-1, anti-topoisomerase I, or anticentromere antibodies. Twenty-eight (93%) patients received corticosteroid therapy, and 8 (27%) patients responded to prednisone alone. Thirteen (43%) patients were treated with methotrexate, and 9 (69%) responded. The mean follow-up was 62 months: 23 (77%) had their disease controlled, 3 (10%) patients were lost to follow-up, and 4 (13%) died (no death occurred because of IIM or its treatment). Therapy was discontinued because of remission in 5 (17%) patients. Cumulative survival rates at 2, 5, and 10 years were 89%, 89%, and 85%, respectively. The presence of autoantibodies to nuclear pore complexes and anti-La autoantibodies, the rare occurrence of anti-Jo-1, autoantibodies, the response to conventional therapies, and a high survival rate may distinguish IIM in French Canadians from that of other reported series.</div>
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<ce:label>*</ce:label>
<ce:note-para>Supported in part by grants from The Arthritis Society ofCanada, Société de sclérose systémique du Québec and Lupus Québec. Dr Uthman is recipient of the Metro Ogryzlo International Fellowship Award.</ce:note-para>
</ce:article-footnote>
<ce:title>Distinctive features of idiopathic inflammatory myopathies inFrench Canadians</ce:title>
<ce:author-group>
<ce:author>
<ce:degrees>MD, MPH</ce:degrees>
<ce:given-name>Imad</ce:given-name>
<ce:surname>Uthman</ce:surname>
<ce:roles>Research Fellow</ce:roles>
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<ce:sup>a</ce:sup>
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<ce:degrees>MD</ce:degrees>
<ce:given-name>Dolores</ce:given-name>
<ce:surname>Vázquez-Abad</ce:surname>
<ce:roles>Assistant Professor of Medicine</ce:roles>
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<ce:sup>a</ce:sup>
</ce:cross-ref>
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<ce:sup>b</ce:sup>
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<ce:sup>c</ce:sup>
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<ce:author>
<ce:degrees>MD, FRCPC, FACP, FACR</ce:degrees>
<ce:given-name>Jean-Luc</ce:given-name>
<ce:surname>Senécal</ce:surname>
<ce:roles>Professor of Medicine</ce:roles>
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<ce:simple-para>This is the first report on idiopathic inflammatory myopathies (IIM) in FrenchCanadians. We reviewed retrospectively 30 French Canadian adults (20 women and 10 men) with IIM seen consecutively over 12 years. The median age at diagnosis was 45 years. The IIM were 8 (27%) primary polymyositis (PM), 9 (30%) primary dermatomyositis (DM), 5 (17%) IIM with neoplasia (lymphoma, breast, esophageal, colonic, and skin cancer) and 8 (27%) IIM with a connective tissue disease (4 with systemic sclerosis, 2 with mixed connective tissue disease, and 2 with rheumatoid arthritis). The most common presenting symptom was proximal muscle weakness (n = 10,33%). Of the remaining 20 patients, 6 (20%) had the onset of their weakness within 1 month of the presenting symptom. Only 3 (10%) patients did not have proximal muscle weakness. Twenty-six (87%) patients had weakness in the pelvic girdle, 25 (83%) in the shoulder girdle, and 7 (23%) in the neck muscles. Other common symptoms included dyspnea on exertion and dysphagia, each present in 13 (43%) patients. Gottron's papules and the heliotrope rash were the most common skin lesions documented in 11 (37%) and 10 (33%) patients, respectively. The serum creatine kinase (CK) level was between 171 and 1,000 U/L in 13 (43%) patients and between 1,001 and 6,000 U/L in 13 (43%) patients. Antinuclear antibodies (ANA) on HEp-2 cells were positive in 16 (53%) patients, of which 2 (13%) expressed autoantibodies to nuclear pore complexes. Autoantibody specificities were anti-La (n = 4,13%), anti-U1RNP (n = 3,10%), and anti-Ro (n = 2,7%). None of the patients expressed anti-Jo-1, anti-topoisomerase I, or anticentromere antibodies. Twenty-eight (93%) patients received corticosteroid therapy, and 8 (27%) patients responded to prednisone alone. Thirteen (43%) patients were treated with methotrexate, and 9 (69%) responded. The mean follow-up was 62 months: 23 (77%) had their disease controlled, 3 (10%) patients were lost to follow-up, and 4 (13%) died (no death occurred because of IIM or its treatment). Therapy was discontinued because of remission in 5 (17%) patients. Cumulative survival rates at 2, 5, and 10 years were 89%, 89%, and 85%, respectively. The presence of autoantibodies to nuclear pore complexes and anti-La autoantibodies, the rare occurrence of anti-Jo-1, autoantibodies, the response to conventional therapies, and a high survival rate may distinguish IIM in French Canadians from that of other reported series.</ce:simple-para>
</ce:abstract-sec>
</ce:abstract>
<ce:keywords class="idt" xml:lang="en">
<ce:section-title>Index words</ce:section-title>
<ce:keyword>
<ce:text>polymyositis</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>autoantibodies to nuclear pore complexes</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>anti-La (SS-B) autoantibodies</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>anti-Jo-1</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>autoantibodies</ce:text>
</ce:keyword>
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</head>
<tail>
<ce:bibliography>
<ce:section-title>References</ce:section-title>
<ce:bibliography-sec>
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<titleInfo lang="en">
<title>Distinctive features of idiopathic inflammatory myopathies inFrench Canadians</title>
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<titleInfo type="alternative" lang="en" contentType="CDATA">
<title>Distinctive features of idiopathic inflammatory myopathies inFrench Canadians</title>
</titleInfo>
<name type="personal">
<namePart type="given">Imad</namePart>
<namePart type="family">Uthman</namePart>
<namePart type="termsOfAddress">MD, MPH</namePart>
<affiliation>Division of Rheumatology, Hôpital Notre-Dame,Montreal, Canada</affiliation>
<affiliation>Department of Medicine, University ofMontreal School of Medicine, Canada</affiliation>
<affiliation>Division of RheumaticDiseases, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA</affiliation>
<description>Research Fellow</description>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Dolores</namePart>
<namePart type="family">Vázquez-Abad</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Division of Rheumatology, Hôpital Notre-Dame,Montreal, Canada</affiliation>
<affiliation>Department of Medicine, University ofMontreal School of Medicine, Canada</affiliation>
<affiliation>Division of RheumaticDiseases, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA</affiliation>
<description>Assistant Professor of Medicine</description>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Jean-Luc</namePart>
<namePart type="family">Senécal</namePart>
<namePart type="termsOfAddress">MD, FRCPC, FACP, FACR</namePart>
<affiliation>Division of Rheumatology, Hôpital Notre-Dame,Montreal, Canada</affiliation>
<affiliation>Department of Medicine, University ofMontreal School of Medicine, Canada</affiliation>
<affiliation>Division of RheumaticDiseases, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA</affiliation>
<affiliation>Address reprint requests to: Jean-Luc Senécal, MD, Division of Rheumatology, Hôpital Notre-Dame, 1560 Sherbrooke St East, Montréal, Québec, Canada H2L 4M1.</affiliation>
<description>Professor of Medicine</description>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre>
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<publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">1996</dateIssued>
<copyrightDate encoding="w3cdtf">1996</copyrightDate>
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<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
</language>
<abstract lang="en">Abstract: This is the first report on idiopathic inflammatory myopathies (IIM) in FrenchCanadians. We reviewed retrospectively 30 French Canadian adults (20 women and 10 men) with IIM seen consecutively over 12 years. The median age at diagnosis was 45 years. The IIM were 8 (27%) primary polymyositis (PM), 9 (30%) primary dermatomyositis (DM), 5 (17%) IIM with neoplasia (lymphoma, breast, esophageal, colonic, and skin cancer) and 8 (27%) IIM with a connective tissue disease (4 with systemic sclerosis, 2 with mixed connective tissue disease, and 2 with rheumatoid arthritis). The most common presenting symptom was proximal muscle weakness (n = 10,33%). Of the remaining 20 patients, 6 (20%) had the onset of their weakness within 1 month of the presenting symptom. Only 3 (10%) patients did not have proximal muscle weakness. Twenty-six (87%) patients had weakness in the pelvic girdle, 25 (83%) in the shoulder girdle, and 7 (23%) in the neck muscles. Other common symptoms included dyspnea on exertion and dysphagia, each present in 13 (43%) patients. Gottron's papules and the heliotrope rash were the most common skin lesions documented in 11 (37%) and 10 (33%) patients, respectively. The serum creatine kinase (CK) level was between 171 and 1,000 U/L in 13 (43%) patients and between 1,001 and 6,000 U/L in 13 (43%) patients. Antinuclear antibodies (ANA) on HEp-2 cells were positive in 16 (53%) patients, of which 2 (13%) expressed autoantibodies to nuclear pore complexes. Autoantibody specificities were anti-La (n = 4,13%), anti-U1RNP (n = 3,10%), and anti-Ro (n = 2,7%). None of the patients expressed anti-Jo-1, anti-topoisomerase I, or anticentromere antibodies. Twenty-eight (93%) patients received corticosteroid therapy, and 8 (27%) patients responded to prednisone alone. Thirteen (43%) patients were treated with methotrexate, and 9 (69%) responded. The mean follow-up was 62 months: 23 (77%) had their disease controlled, 3 (10%) patients were lost to follow-up, and 4 (13%) died (no death occurred because of IIM or its treatment). Therapy was discontinued because of remission in 5 (17%) patients. Cumulative survival rates at 2, 5, and 10 years were 89%, 89%, and 85%, respectively. The presence of autoantibodies to nuclear pore complexes and anti-La autoantibodies, the rare occurrence of anti-Jo-1, autoantibodies, the response to conventional therapies, and a high survival rate may distinguish IIM in French Canadians from that of other reported series.</abstract>
<note>Supported in part by grants from The Arthritis Society ofCanada, Société de sclérose systémique du Québec and Lupus Québec. Dr Uthman is recipient of the Metro Ogryzlo International Fellowship Award.</note>
<subject lang="en">
<genre>Index words</genre>
<topic>polymyositis</topic>
<topic>autoantibodies to nuclear pore complexes</topic>
<topic>anti-La (SS-B) autoantibodies</topic>
<topic>anti-Jo-1</topic>
<topic>autoantibodies</topic>
</subject>
<relatedItem type="host">
<titleInfo>
<title>Seminars in Arthritis and Rheumatism</title>
</titleInfo>
<titleInfo type="abbreviated">
<title>YSARH</title>
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