A subluxing arthropathy associated with the anti-Jo-1 antibody in polymyositis/dermatomyositis.
Of 180 patients with polymyositis/dermatomyositis (PM/DM) seen at the University of Pittsburgh and affiliated hospitals since 1975, 21 of 100 tested positive for the anti-Jo-1 antibody. Sixteen of the 21 patients were women and 18 were white. Fifteen had adult PM, 4 had myositis in overlap with scleroderma, and 2 had adult DM. Evidence of interstitial lung disease was found in 12 of 18 anti-Jo-1 positive patients (67%), but in only 15 of 79 anti-Jo-1 negative patients (19%) (P less than 0.0002). The 21 anti-Jo-1 positive patients were divided into 3 separate groups based on the observed articular findings. Four patients had a deforming, predominantly nonerosive arthropathy with subluxations of the distal interphalangeal joints, especially the thumbs. Eight patients had a nondeforming arthropathy primarily affecting the small joints of the hands, wrists, shoulders, and knees. Those with deformities had a longer duration of arthritis compared with those with nondeforming arthropathy (mean 14.5 years versus 3.3 years). Nine anti-Jo-1 positive patients had no joint arthropathy. Three of 4 patients with deformities have required articular reconstructive surgery for subluxation, with 2 having associated subcutaneous calcinosis.
Oddis
C V
CV
Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, PA 15261.
Medsger
T A
TA
Cooperstein
L A
LA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis*; D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology; D003882:Dermatomyositis / Q000150:complications / Q000276:immunology*; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications / Q000276:immunology*; D011859:Radiography
D000974:Antibodies, Antinuclear; C046750:Jo-1 antibody