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Rheumatology Advance Access published online on May 25, 2006

Rheumatology, doi:10.1093/rheumatology/kel161
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
Received February 6, 2006
Accepted April 4, 2006

Concise Report

Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancy

K. Kaji 1, M. Fujimoto 1 *, M. Hasegawa 1, M. Kondo 1, Y. Saito 1, K. Komura 1, T. Matsushita 1, H. Orito 1, Y. Hamaguchi 1, K. Yanaba 2, M. Itoh 2, Y. Asano 3, M. Seishima 4, F. Ogawa 5, S. Sato 5, and K. Takehara 1

1 Department of Dermatology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
2 Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan
3 Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
4 Department of Dermatology, Ogaki Municipal Hospital, Gifu, Japan
5 Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

* To whom correspondence should be addressed.
M. Fujimoto, E-mail: fujimoto-m{at}umin.ac.jp


   Abstract

Objective. Myositis-specific autoantibodies (MSAs) are a useful tool in diagnosis, defining clinical subsets and predicting prognosis of dermatomyositis (DM) and polymyositis (PM). In this study, we identified a novel MSA reactive with 155 and 140 kDa nuclear proteins [anti-155/140 antibody (Ab)] and determined the clinical feature of DM patients positive for this autoantibody (autoAb).

Methods. Sera from 52 Japanese patients with DM, 9 with PM, 48 with systemic lupus erythematosus (SLE), 126 with systemic sclerosis and 18 with idiopathic interstitial pneumonia were examined by immunoprecipitation assays. Positive sera were further characterized by immunodepletion and immunofluorescence staining.

Results. Seven of the 52 (13%) Japanese patients with DM immunoprecipitated 155 and 140 kDa proteins from 35S-labelled K562 leukaemia cell extract. No patients with SLE, systemic sclerosis or idiopathic interstitial pneumonia as well as healthy controls were positive for this autoAb. Patients with anti-155/140 Ab developed heliotrope rash, Gottron's papules or sign and flagellate erythema significantly more frequently than those negative. Notably, internal malignancy was found at significantly higher frequency in those positive than those negative (71 vs 11%; P < 0.005). In contrast, none of these patients positive for this autoAb had interstitial lung disease.

Conclusions. This novel MSA is associated with cancer-associated DM and may serve as a diagnostic serological marker for this specific subset.

Keywords: Dermatomyositis; Myositis-specific autoantibodies; Malignancy; Interstitial lung disease.
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