Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis
To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (JIIM).
Univariable and multivariable multinomial logistic regression analyses were performed in a large JIIM registry (n=365), including demographics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms.
Multivariable associations with chronic or polycyclic courses compared to monocyclic included myositis-specific autoantibodies (multinomial odds ratio (M-OR) 4.2 and 2.8, respectively), myositis-associated autoantibodies (M-OR 4.8 and 3.5), and a documented infection within six months of illness onset (M-OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to polycyclic. Furthermore, a severe illness onset was associated with chronic compared to monocyclic or polycyclic courses (M-OR 2.1 and 2.6), while anti-p155/140 autoantibodies were associated with chronic or polycyclic courses compared to monocyclic (M-OR 3.9 and 2.3). Additional univariable associations of chronic compared to monocyclic course included photosensitivity, "V-sign" or "Shawl-sign" rashes, and cuticular overgrowth (OR 2.2-3.2). The mean and highest ultraviolet index in the month before diagnosis were associated with a chronic compared to polycyclic course in boys (OR 1.3 and 1.5), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2).
Myositis autoantibodies, in particular anti-p155/140, and a number of early clinical features and environmental exposures were associated with a chronic course in patients with JIIM. These findings suggest early factors can be identified that are associated with poorer outcomes in JIIM. This article is protected by copyright. All rights reserved.
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 November 2015.
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