Article

Paraneoplastic myopathy.

Division of Clinical Immunology, 3rd Department of Internal Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
Current opinion in rheumatology (impact factor: 4.6). 09/2009; 21(6):594-8. DOI:10.1097/BOR.0b013e3283317fa5 pp.594-8
Source: PubMed

ABSTRACT It has been recognized for some time now, that compared with the normal population, patients with idiopathic inflammatory myopathies (IIM) live with an increased risk of developing malignancy. In the majority of these patients, cancer-associated myositis appears to have some paraneoplastic features. The aim of the present review is to describe new data that explain the connection between myositis and malignant diseases, as well as to highlight its value in the current management of these patients.
Antigen expressions and patterns shared by regenerating muscle and cancers raise questions about whether myositis cases without clinically observable cancer may represent a fully successful antitumor immune response with bystander damage to regenerating muscle. The discovery of anti-155/140 autoantibody may aid in the better diagnosis of adult IIM patients with a higher risk of malignancy. It also may help the better understanding of paraneoplastic myositis.
Cancer-associated myositis differs from primary myositis in many aspects. Prognosis and life-expectancy are determined by the underlying malignancy. Therefore, patient-specific examinations for detection of an underlying cancer are important in the management of patients. Recent clinical findings and new possibilities in immunoserological testing may result in the elaboration of an evidence-based recommendation for cancer screening programs in patients with IIM in the future.

0 0
 · 
0 Bookmarks
 · 
49 Views
  • Source
    Article: Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan.
    Yi-Ju Chen, Chun-Ying Wu, Yu-Lin Huang, Chang-Bi Wang, Jui-Lung Shen, Yun-Ting Chang
    [show abstract] [hide abstract]
    ABSTRACT: The association of idiopathic inflammatory myositis (IIM) and malignancies has been reported, but rarely in Asian countries. Our aim was to investigate the risk of cancer among IIM patients without a prior history of malignancies, in Taiwan. We conducted a nationwide cohort study of 1,012 patients with dermatomyositis (DM) and 643 patients with polymyositis (PM), but without prior history of malignancies, utilizing the National Health Insurance Database from 1997 to 2007. Standardized incidence ratios (SIRs) of cancers were analyzed. A total of 95 cancers (9.4%) in DM and 33 cancers (4.4%) in PM were identified. Overall cancer risk was significantly elevated in DM patients (SIR = 5.11, 95% confidence interval [CI] = 5.01 to 5.22) and PM patients (SIR = 2.15, 95% CI = 2.08 to 2.22). Most cancers were detected in the first year of observation. The risk of cancer decreased with observation time, yet remained elevated compared with the general population in both study groups after 5 years of follow-up. DM was associated with sustained elevated risk of cancers in every age group, whereas the risk of cancer in PM was highest in younger patients and decreased with age. DM patients were at the greatest risk of cancers of the nasopharynx, lungs and hematopoietic malignancies. Patients with IIM are at increased risk for cancer and should receive age-appropriate and gender-appropriate malignancy evaluations, with additional assessment for nasopharyngeal, lung and hematologic malignancy following diagnosis, and with continued vigilance for development of cancers in follow-up.
    Arthritis research & therapy 01/2010; 12(2):R70. · 4.27 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

adult IIM patients
 
bystander damage
 
cancer screening programs
 
cancer-associated myositis
 
clinically observable cancer
 
current management
 
evidence-based recommendation
 
idiopathic inflammatory myopathies
 
myositis cases
 
new data
 
new possibilities
 
paraneoplastic features
 
paraneoplastic myositis
 
patient-specific examinations
 
primary myositis
 
Recent clinical findings
 
regenerating muscle
 
successful antitumor immune response
 
underlying cancer
 
underlying malignancy