The British Journal of Rheumatology, Vol 36, 1067-1074, Copyright © 1997 by British Society for Rheumatology
MJ Garton and DA Isenberg
Myositis is a rare but well-recognized complication of systemic lupus
erythematosus (SLE). It is reputed to be milder than primary myositis in
terms of morbidity and treatment response. This study compares clinical and
laboratory features of idiopathic inflammatory myositis in patients with
and without evidence of SLE overlap. We performed a case note review of 30
patients with probable or definite polymyositis/dermatomyositis of whom 11
also had definite or probable SLE. Lupus patients were slightly younger at
diagnosis than those with primary disease, and more likely to be female. At
presentation, quadriceps strength (expressed as a percentage of expected)
was significantly reduced in both the lupus (48.9%; 95% CI 29.0-70.4%) and
primary (52.0%; 95% CI 43.6-59.4%) myositis groups, and serum creatine
phosphokinase (expressed as a multiple of the upper limit of normal) was
significantly elevated (11.2; 95% CI 5.3-29.1 vs 10.7; 95% CI 6.1- 17.6).
During a mean (S.D.) follow-up period of 7.4 (4.1) yr, both groups tended
to follow either a relapsing and remitting, or a chronic persistent course,
and when last seen quadriceps muscle strength remained significantly
depressed. One of the lupus patients and two of the primary myositis
patients died due to direct complications of the disease, and one further
death was attributable to a complication of therapy. Our results suggest
that lupus myositis is often as severe as primary disease and should be
treated with equal vigour.
ORIGINAL PAPERS
Clinical features of lupus myositis versus idiopathic myositis: a review of 30 cases
Bloomsbury Rheumatology Unit, Department of Medicine, University College, London.
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