Guillaume Lefèvre1, Alain Meyer1, David Launay1, Irène Machelart1, Michel DeBandt1, Julien Michaud1, Anne Tournadre1, Pascal Godmer1, Jean-Emmanuel Kahn1, Aurélie Behra-Marsac1, Marie-Agnès Timsit1, Nicolas Schleinitz1, Daniel Wendling1, Sylvie Melac-Ducamp1, Philippe Boyer1, Anne Peretz1, Thierry Lequerré1, Christophe Richez1, Lidwine Stervinou-Wemeau1, Sandrine Morell-Dubois1, Marc Lambert1, Sylvain Dubucquoi1, Benoit Wallaert1, Olivier Benveniste1, René-Marc Flipo1, Pierre-Yves Hatron1, Jean Sibilia1, Eric Hachulla1, Baptiste Hervier1. 1. Service de Médecine Interne, Unité d'Immunologie Clinique, Centre de Référence pour les Maladies Auto-Immunes et Systémiques Rares, Hôpital Claude Huriez, CHRU de Lille, Université Lille Nord de France, Laboratoire d'Immunologie, EA 2686, IMPRT IFR 114, CHRU de Lille, Faculté de Médecine H. Warembourg, Université Lille Nord de France, Lille, Service de Rhumatologie, Centre de Référence Maladies Systémiques Rares, CHU Hautepierre, Strasbourg, Service de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, Service de Rhumatologie, CHU Fort-De-France, La Meynard, Fort-De-France, Service de Rhumatologie, CHU de Rouen, Hôpitaux de Rouen, Rouen, Service de Rhumatologie, CHU Clermont-Ferrand, Clermont-Ferrand, Service de Médecine Interne, Maladies Infectieuses et Tropicales, Hématologie, CH Bretagne Atlantique, Vannes-Auray, Vannes, Service de Médecine Interne, Hôpital Foch, AP-HP, Suresnes, Service de Rhumatologie, CHU de Limoges, Limoges, Service de Rhumatologie, CHU de la Cavale-Blanche, Brest, Service de Médecine Interne, Hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, Service de Rhumatologie, CHRU Jean Minjoz, Besançon, Service de Médecine, Pôle A, Rhumatologie, CH de Nevers, Nevers, Rhumatologue, Château-Thierry, France, Service de Rhumatologie - Médecine Interne, CHU Brugmann, Brussels, Belgium, Service de Pneumologie et Immuno-Allergologie, Centre de Compétence des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU de Lille, Université de Lille Nord de France, Lille, Service de Médecine Interne 1, DHU-I2B, Centre de Référence des Maladies Neuromusculaires Paris-Est, Hôpital de la Pitié-Salpêtrière, AP-HP, Université Paris 6 Pierre et Marie Curie, Paris, Service de Rhumatologie, Hôpital Roger Salengro, CHU de Lille, Université Lille Nord de France and Service de Médecine Interne 2, Centre de Référence Lupus et SAPL, Hôpital de la Pitié-Salpêtrière, AP-HP,
Abstract
OBJECTIVE: The aim of this study was to determine the frequency and characteristics of antisynthetase syndrome (ASS) revealed by polyarthritis. METHODS: First we conducted a retrospective single-centre study to assess the frequency of ASS patients who presented with polyarthritis without pulmonary and/or muscle symptoms. Secondly, we conducted a larger, multicentre study in order to describe the clinical characteristics of these patients. Exclusion criteria were the presence of RF, the presence of ACPA and overlap with another CTD. RESULTS: In the single-centre study, polyarthritis was the first manifestation in 12 of 45 ASS patients (27%). An additional 28 patients were collected for the multicentre study, resulting in a total population of 40 ASS patients who presented with polyarthritis. The mean delay from polyarthritis onset to ASS diagnosis was 27 months (s.d. 40). Pulmonary and muscle symptoms were uncommon at ASS diagnosis (40% and 32.5%, respectively) and were dramatically delayed [mean delay after polyarthritis onset of 41 months (s.d. 53) and 21 months (s.d. 14), respectively]. Mechanic's hands and cutaneous signs of DM occurred in 25% and 22.5%, respectively, with a mean delay of 10 months (s.d. 10) and 31 months (s.d. 21), respectively. When present (32%), RP was the earliest non-articular manifestation [mean delay 3 months (s.d. 23) after polyarthritis onset]. On HEp-2 cells, antinuclear and/or cytoplasmic fluorescence was found in 70% of cases, with specificity for various anti-aminoacyl tRNA synthetase (anti-ARS) antibodies. CONCLUSION: ASS may be revealed by polyarthritis. To decrease the delay in diagnosis of ASS, pulmonary and muscle symptoms and anti-ARS antibodies might usefully be searched for in seronegative polyarthritis patients, especially in those with RP.
OBJECTIVE: The aim of this study was to determine the frequency and characteristics of antisynthetase syndrome (ASS) revealed by polyarthritis. METHODS: First we conducted a retrospective single-centre study to assess the frequency of ASSpatients who presented with polyarthritis without pulmonary and/or muscle symptoms. Secondly, we conducted a larger, multicentre study in order to describe the clinical characteristics of these patients. Exclusion criteria were the presence of RF, the presence of ACPA and overlap with another CTD. RESULTS: In the single-centre study, polyarthritis was the first manifestation in 12 of 45 ASSpatients (27%). An additional 28 patients were collected for the multicentre study, resulting in a total population of 40 ASSpatients who presented with polyarthritis. The mean delay from polyarthritis onset to ASS diagnosis was 27 months (s.d. 40). Pulmonary and muscle symptoms were uncommon at ASS diagnosis (40% and 32.5%, respectively) and were dramatically delayed [mean delay after polyarthritis onset of 41 months (s.d. 53) and 21 months (s.d. 14), respectively]. Mechanic's hands and cutaneous signs of DM occurred in 25% and 22.5%, respectively, with a mean delay of 10 months (s.d. 10) and 31 months (s.d. 21), respectively. When present (32%), RP was the earliest non-articular manifestation [mean delay 3 months (s.d. 23) after polyarthritis onset]. On HEp-2 cells, antinuclear and/or cytoplasmic fluorescence was found in 70% of cases, with specificity for various anti-aminoacyl tRNA synthetase (anti-ARS) antibodies. CONCLUSION:ASS may be revealed by polyarthritis. To decrease the delay in diagnosis of ASS, pulmonary and muscle symptoms and anti-ARS antibodies might usefully be searched for in seronegative polyarthritispatients, especially in those with RP.
Authors: Lorenzo Cavagna; Laura Nuño; Carlo Alberto Scirè; Marcello Govoni; Francisco Javier Lopez Longo; Franco Franceschini; Rossella Neri; Santos Castañeda; Walter Alberto Sifuentes Giraldo; Roberto Caporali; Florenzo Iannone; Enrico Fusaro; Giuseppe Paolazzi; Raffaele Pellerito; Andreas Schwarting; Lesley Ann Saketkoo; Norberto Ortego-Centeno; Luca Quartuccio; Elena Bartoloni; Christof Specker; Trinitario Pina Murcia; Renato La Corte; Federica Furini; Valentina Foschi; Javier Bachiller Corral; Paolo Airò; Ilaria Cavazzana; Julia Martínez-Barrio; Michelle Hinojosa; Margherita Giannini; Simone Barsotti; Julia Menke; Kostantinos Triantafyllias; Rosetta Vitetta; Alessandra Russo; Gianluigi Bajocchi; Elena Bravi; Giovanni Barausse; Roberto Bortolotti; Carlo Selmi; Simone Parisi; Carlomaurizio Montecucco; Miguel Angel González-Gay Journal: Medicine (Baltimore) Date: 2015-08 Impact factor: 1.817