title: Oropharyngeal Dysphagia in Dermatomyositis: Associations with Clinical and Laboratory Features Including Autoantibodies.
abstract: Dysphagia develops with low frequency in patients with dermatomyositis. Our objective was to determine the clinical and laboratory features that can estimate the development of dysphagia in dermatomyositis.
  
  
  
  This study included 92 Japanese patients with adult-onset dermatomyositis. The associations between dysphagia and clinical and laboratory features including disease-specific autoantibodies determined by immunoprecipitation assays were analyzed.
  
  
  
  Videofluoroscopy swallow study (VFSS) was performed for all patients with clinical dysphagia (n = 13, 14.1%) but not for patients without clinical dysphagia. Typical findings of dysphagia (pharyngeal pooling, n = 11 and/or nasal regurgitation, n = 4) was detected by VFSS in all patients with clinical dysphagia. Eleven patients with dysphagia (84.6%) had anti-transcription intermediary factor 1γ (TIF-1γ) antibody. By univariate analysis, the average age and the male to female ratio, internal malignancy, and anti-TIF-1γ antibody were significantly higher and the frequency of interstitial lung diseases and manual muscle testing (MMT) scores of sternomastoid and dertoid muscles were significantly lower in patients with dysphagia than in patients without dysphagia. Among patients with anti-TIF-1γ antibody, the mean age, the ratios of male to female and internal malignancy were significantly higher and mean MMT scores of sternomastoid muscle were significantly lower in patients with dysphagia compared with patients without dysphagia. By multivariable analysis, the risk of dysphagia was strongly associated with the existence of internal malignancy and ant-TIF-1γ antibody and was also associated with reduced scores of manual muscle test of sternomastoid muscle. Dysphagia was markedly improved after the treatment against myositis in all 13 patients.
  
  
  
  These findings indicate that dysphagia can develop frequently in patients with internal malignancy, anti-TIF-1γ antibody, or severe muscle weakness of sternomastoid muscle.
authors.affiliation: Department of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Mugii
authors.affiliation: Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsushita
authors.affiliation: Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Hamaguchi
authors.affiliation: Department of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Sacihe
authors.initials: S
authors.lastname: Oohata
authors.affiliation: Department of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okita
authors.affiliation: Department of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Tetsutarou
authors.initials: T
authors.lastname: Yahata
authors.affiliation: Division of Rehabilitation Science, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Fujiko
authors.initials: F
authors.lastname: Someya
authors.affiliation: Division of Rehabilitation Science, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.affiliation: Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Fujimoto
authors.affiliation: Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Takehara
mesh_terms: D001323:Autoantibodies / Q000276:immunology*; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications* / Q000276:immunology* / Q000503:physiopathology; D003882:Dermatomyositis / Q000150:complications* / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014741:Video Recording
chemical_list: D001323:Autoantibodies