Introduction. Idiopathic inflammatory myopathies (IIMs) are a group of chronic systemic autoimmune diseases that mainly affect the skeletal muscle. The common subtypes include adult dermatomyositis (DM), polymyositis (PM), and inclusion body myositis (IBM). Most of the earlier studies that described the clinical characteristics of IIM as well as their association with cancer were conducted in Western population. Our study is the first systematic review that summarizes the clinical data of DM/PM in Asian population. Methods. We identified 14 case series of DM/PM that met our eligibility criteria. We then compared this data with that from previous reports from Europe and North America. Results. Our systematic review included 2518 patients. Dermatomyositis is more common, with the ratio of dermatomyositis to polymyositis being 1.36？:？1. 69% of them were females with mean age of 45.5 years. Extramuscular manifestations, including arthritis/arthralgia, dysphagia, and interstitial lung disease, are found in one-third of the patients. Malignancy was found in 10% of patients, with lung and nasopharyngeal carcinomas being the most common malignancies associated with these myopathies. Conclusion. Clinical presentation of PM/DM appears to be similar in both Western and Asian populations. However, the type of associated malignancies in Asians differs from that in Caucasians. Ethnic background should be one of the factors that clinicians should consider while screening for malignancy. 1. Introduction Idiopathic inflammatory myopathies (IIMs) are a group of chronic systemic autoimmune diseases that mainly affect the skeletal muscle. The common subtypes include adult dermatomyositis (DM), polymyositis (PM), and inclusion body myositis (IBM). In 1975, Bohan and Peter proposed the diagnostic criteria for DM and PM using clinical, laboratory, and pathological features which remain to be the gold standard for use in clinical studies [1, 2]. Malignancies associated with these myopathies have been extensively reported in the medical literature since 1916 and then confirmed by subsequent metaanalyses [3–5]. Most of the earlier epidemiological studies that describe the clinical characteristics of IIM as well as their association with cancer come from Western population [4–6]. However, in recent years, several case series have been reported in the Asian population. This study aims to report a systematic review of case series reported exclusively in Asia in order to better characterize the demographics, the clinical data, and the associated malignancies in patients with DM/PM
References
[1]
A. Bohan and J. B. Peter, “Polymyositis and dermatomyositis—I,” The New England Journal of Medicine, vol. 292, no. 7, pp. 344–347, 1975.
[2]
A. Bohan and J. B. Peter, “Polymyositis and dermatomyositis (Second of two parts),” The New England Journal of Medicine, vol. 292, no. 8, pp. 403–407, 1975.
[3]
G. Stertz, “Polymyositis,” Berliner Klinische Wochenschrift, vol. 53, p. 489, 1916.
[4]
D. Zantos, Y. Zhang, and D. Felson, “The overall and temporal association of cancer with polymyositis and dermatomyositis,” Journal of Rheumatology, vol. 21, no. 10, pp. 1855–1859, 1994.
[5]
R. Buchbinder and C. L. Hill, “Malignancy in patients with inflammatory myopathy,” Current Rheumatology Reports, vol. 4, no. 5, pp. 415–426, 2002.
[6]
V. Madan, H. Chinoy, C. E. M. Griffiths, and R. G. Cooper, “Defining cancer risk in dermatomyositis. Part I,” Clinical and Experimental Dermatology, vol. 34, no. 4, pp. 451–455, 2009.
[7]
T. H. Yen, P. C. Lai, C. C. Chen, S. Hsueh, and J. Y. Huang, “Renal involvement in patients with polymyositis and dermatomyositis,” International Journal of Clinical Practice, vol. 59, no. 2, pp. 188–193, 2005.
[8]
Y. Yamasaki, H. Yamada, T. Nozaki et al., “Unusually high frequency of autoantibodies to PL-7 associated with milder muscle disease in Japanese patients with polymyositis/dermatomyositis,” Arthritis & Rheumatism, vol. 54, no. 6, pp. 2004–2009, 2006.
[9]
Y. L. Huang, Y. J. Chen, M. W. Lin et al., “Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study,” British Journal of Dermatology, vol. 161, no. 4, pp. 854–860, 2009.
[10]
C. F. Kuo, L. C. See, K. H. Yu, et al., “Incidence, cancer risk and mortality of dermatomyositis and polymyositis in Taiwan: a nationwide population study,” British Journal of Dermatology, vol. 165, no. 6, pp. 1273–1279, 2011.
[11]
Y. Yamasaki, H. Yamada, M. Ohkubo, et al., “Long term survival and associated risk factors in patients with adult-onset idiopathic inflammatory myopathies and amyopathic dermatomyositis: experience in a single institute in Japan,” The Journal of Rheumatology, vol. 38, no. 8, pp. 1636–1643, 2011.
[12]
K. H. Yu, Y. J. Wu, C. F. Kuo, et al., “Survival analysis of patients with dermatomyositis and polymyositis: analysis of 192 Chinese cases,” Clinical Rheumatology, vol. 30, no. 12, pp. 1595–1601, 2011.
[13]
C. N. Yeh, S. C. Chen, T. L. Hwang, M. F. Chen, C. C. Liaw, and H. L. Chan, “Breast carcinoma in patients with dermatomyositis: a retrospective analysis of eight cases,” Chang Gung Medical Journal, vol. 25, no. 6, pp. 374–380, 2002.
[14]
K. O. Wong, “Dermatomyositis: a clinical investigation of twenty-three cases in Hong Kong,” British Journal of Dermatology, vol. 81, no. 7, pp. 544–547, 1969.
[15]
T. Matsushita, M. Hasegawa, M. Fujimoto et al., “Clinical evaluation of anti-aminoacyl tRNA synthetase antibodies in Japanese patients with dermatomyositis,” Journal of Rheumatology, vol. 34, no. 5, pp. 1012–1018, 2007.
[16]
M. L. Prasad, C. Sarkar, S. Roy et al., “Idiopathic inflammatory myopathy: clinicopathological observations in the Indian population,” British Journal of Rheumatology, vol. 31, no. 12, pp. 835–839, 1992.
[17]
E. T. Koh, A. Seow, B. Ong, P. Ratnagopal, H. Tjia, and H. H. Chng, “Adult onset polymyositis/dermatomyositis: clinical and laboratory features and treatment response in 75 patients,” Annals of the Rheumatic Diseases, vol. 52, no. 12, pp. 857–861, 1993.
[18]
C. R. Maoz, P. Langevitz, A. Livneh et al., “High incidence of malignancies in patients with dermatomyositis and polymyositis: an 11-year analysis,” Seminars in Arthritis and Rheumatism, vol. 27, no. 5, pp. 319–324, 1998.
[19]
W. Louthrenoo, N. Weerayutwattana, N. Lertprasertsuke, and W. Sukitawut, “Serum muscle enzymes, muscle pathology and clinical muscle weakness: correlation in Thai patients with polymyositis/dermatomyositis,” Journal of the Medical Association of Thailand, vol. 85, no. 1, pp. 26–32, 2002.
[20]
R. Porkodi, K. Shanmuganandan, M. Parthiban, R. Madhavan, and P. Rajendran, “Clinical spectrum of inflammatory myositis in South India—a ten year study,” Journal of Association of Physicians of India, vol. 50, no. 10, pp. 1255–1258, 2002.
[21]
N. Wakata, T. Kurihara, E. Saito, and M. Kinoshita, “Polymyositis and dermatomyositis associated with malignancy: a 30-year retrospective study,” International Journal of Dermatology, vol. 41, no. 11, pp. 729–734, 2002.
[22]
E. H. Kang, E. B. Lee, K. C. Shin et al., “Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis,” Rheumatology, vol. 44, no. 10, pp. 1282–1286, 2005.
[23]
S. W. Lee, S. Y. Jung, M. C. Park, Y. B. Park, and S. K. Lee, “Malignancies in Korean patients with inflammatory myopathy,” Yonsei Medical Journal, vol. 47, no. 4, pp. 519–523, 2006.
[24]
K. Tani, R. Tomioka, K. Sato et al., “Comparison of clinical course of polymyositis and dermatomyositis: a follow-up study in Tokushima University Hospital,” Journal of Medical Investigation, vol. 54, no. 3-4, pp. 295–302, 2007.
[25]
Y. J. Chen, C. Y. Wu, Y. L. Huang, C. B. Wang, J. L. Shen, and Y. T. Chang, “Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan,” Arthritis Research and Therapy, vol. 12, no. 2, article R70, 2010.
[26]
K. N. Mustafa and S. S. Dahbour, “Clinical characteristics and outcomes of patients with idiopathic inflammatory myopathies from Jordan 1996–2009,” Clinical Rheumatology, vol. 29, no. 12, pp. 1381–1385, 2010.
[27]
K. Azuma, H. Yamada, M. Ohkubo et al., “Incidence and predictive factors for malignancies in 136 Japanese patients with dermatomyositis, polymyositis and clinically amyopathic dermatomyositis,” Modern Rheumatology, vol. 21, no. 2, pp. 178–183, 2011.
[28]
M. W. So, B. S. Koo, Y. G. Kim, C. K. Lee, and B. Yoo, “Idiopathic inflammatory myopathy associated with malignancy: a retrospective cohort of 151 Korean patients with dermatomyositis and polymyositis,” The Journal of Rheumatology, vol. 38, no. 11, pp. 2432–2435, 2011.
[29]
C. L. Teh, J. S. Wong, and H. H. Soo, “Polymyositis and dermatomyositis in Sarawak: a profile of patients treated in the Sarawak general hospital,” Rheumatology International, vol. 32, no. 1, pp. 265–268, 2012.
[30]
D. Stockton, V. R. Doherty, and D. H. Brewster, “Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study,” British Journal of Cancer, vol. 85, no. 1, pp. 41–45, 2001.
[31]
B. Sigurgeirsson, B. Lindelof, O. Edhag, and E. Allander, “Risk of cancer in patients with dermatomyositis or polymyositis—a population-based study,” The New England Journal of Medicine, vol. 326, no. 6, pp. 363–367, 1992.
[32]
W. H. Chow, G. Gridley, L. Mellemkjar, J. K. Mclaughlin, J. H. Olsen, and J. F. Fraumeni, “Cancer risk following polymyositis and dermatomyositis: a nationwide cohort study in Denmark,” Cancer Causes and Control, vol. 6, no. 1, pp. 9–13, 1995.
[33]
G. S. Hoffman, W. A. Franck, D. A. Raddatz, and L. Stallones, “Presentation, treatment, and prognosis of idiopathic inflammatory muscle disease in a rural hospital,” American Journal of Medicine, vol. 75, no. 3, pp. 433–438, 1983.
[34]
C. L. Hill, Y. Zhang, B. Sigurgeirsson et al., “Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study,” The Lancet, vol. 357, no. 9250, pp. 96–100, 2001.
[35]
S. Okada, E. Weatherhead, I. N. Targoff, R. Wesley, and F. W. Miller, “Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease,” Arthritis & Rheumatism, vol. 48, no. 8, pp. 2285–2293, 2003.
[36]
I. Marie, P. Y. Hatron, H. Levesque et al., “Influence of age on characteristics of polymyositis and dermatomyositis in adults,” Medicine, vol. 78, no. 3, pp. 139–147, 1999.
[37]
R. DeVere and W. G. Bradley, “Polymyositis: its presentation, morbidity and mortality,” Brain, vol. 98, no. 4, pp. 637–666, 1975.
[38]
I. Marie, E. Hachulla, P. Y. Hatron et al., “Polymyositis and dermatomyositis: short term and longterm outcome, and predictive factors of prognosis,” Journal of Rheumatology, vol. 28, no. 10, pp. 2230–2237, 2001.
[39]
T. Mimori, R. Nakashima, and Y. Hosona, “Interstitial lung disease in myositis: clinical subsets, biomarkers, and treatment,” Current Rheumatology Reports, vol. 14, no. 3, pp. 264–274, 2012.
[40]
M. Hirakata and S. Nagai, “Interstitial lung disease in polymyositis and dermatomyositis,” Current Opinion in Rheumatology, vol. 12, no. 6, pp. 501–508, 2000.
[41]
F. C. Arnett, I. N. Targoff, T. Mimori, R. Goldstein, N. B. Warner, and J. D. Reveille, “Interrelationship of major histocompatibility complex class II alleles and autoantibodies in four ethnic groups with various forms of myositis,” Arthritis & Rheumatism, vol. 39, no. 9, pp. 1507–1518, 1996.
[42]
R. Brouwer, G. J. Hengstman, E. Vree, et al., “Autoantibody profiles in the sera of European patients with myositis,” Annals of the Rheumatic Diseases, vol. 60, no. 2, pp. 116–123, 2001.
[43]
D. Vázquez-Abad and N. F. Rothfield, “Sensitivity and specificity of anti-Jo-1 antibodies in autoimmune diseases with myositis,” Arthritis & Rheumatism, vol. 39, no. 2, pp. 292–296, 1996.
[44]
E. A. Shamim, L. G. Rider, T. P. O'Hanlon, et al., “Clinical, serologic and genetic differences between U.S. Caucasians and Meso-Americans with idiopathic inflammatory myopathy (IIM),” Arthritis & Rheumatism, vol. 42, p. S403, 1999.
[45]
I. Uthman, D. Vazquez-Abad, and J. L. Senecal, “Distinctive features of idiopathic inflammatory myopathies in French Canadians,” Seminars in Arthritis and Rheumatism, vol. 26, no. 1, pp. 447–458, 1996.
