Journal of Diagnostics Concepts & Practice ›› 2023, Vol. 22 ›› Issue (03): 247-254.doi: 10.16150/j.1671-2870.2023.03.07

• Original articles • Previous Articles     Next Articles

Clinical characteristics of anti-SRP antibody positive immune-mediated necrotizing myopathy with anti-TRIM21/Ro52 antibody positive

XU Li, GAO Huajie, YANG Mengge, LI Yue, JI Suqiong()   

  1. Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan 430000, China
  • Received:2023-02-02 Online:2023-06-25 Published:2023-11-17

Abstract:

Objective: To explore the clinical characteristics of anti-SRP antibody positive immune-mediated necrotizing myopathy (IMNM) with anti-TRIM21/Ro52 antibody positive. Methods: The data of 57 patients with anti-SRP antibody positive (+) IMNM admitted to the Neurology Department at Tongji Hospital between 2010 and 2021 were retrospectively analyzed. Patients were divided into anti-TRIM21/Ro52 antibody-positive group (positive group) and anti-TRIM21/Ro52 antibody-negative group (negative group) according to serum myositis-associated autoantibody (MAA) anti-TRIM21/Ro52 antibody. The clinical characteristics, laboratory test results, outcomes and prognosis of the two groups were compared and analyzed. Results: Patients with anti-SRP antibody(+) IMNM were enrolled, including anti-TRIM21/Ro52 positive patients (n=23, positive group) and anti-TRIM21/Ro52 negative patients (n=34, negative group). Higher prevalence of interstitial lung disease (ILD) (21.7% vs 2.9%; P=0.034) and high titer antinuclear antibodies (69.5% vs 32.3%; P=0.008) were observed in positive group than those in negative group, as well as the serum neutrophil counts(8.18×109/L vs 3.93×109/L, P=0.034)and white blood cell counts(11.685×109/L vs 6.98×109/L, P=0.044). All above indicators were positively correlated with the expression of anti-TRIM21/Ro52 antibody(r=0.312, 0.351, 0.290, 0.274, P=0.019, 0.008, 0.035, 0.043). Fifty-seven patients of anti-SRP antibody (+) IMNM were followed up for 83 (62-96) months. Fifty-one (89.4%) patients received glucocorticoid therapy (or) combination with immunotherapy, and 22 (95.6%) patients in positive group achieved remission, and one patient (4.3%) was lost to follow-up. Among 29 (85.3%) patients of negative group who received immunotherapy, 24 patients (70.6%) were improved, while the remaining 5 patients (14.7%) were not improved, 1 patient (2.9%) was lost to follow-up. Conclusions: Anti-SRP (+) IMNM patients with anti-TRIM21/Ro52 antibody are more likely to be complicated with ILD and have higher inflammatory indicators and ANA titer levels. IMNM patients with anti-TRIM21/Ro52 antibody positive respond well to corticosteroids and immunosuppressive therapy.

Key words: Immune-mediated necrotizing myopathy, Anti-SRP antibody, Anti-TRIM21/Ro52 antibody, Clinical characteristics, Prognosis

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