{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T21:10:26Z","timestamp":1728162626844},"reference-count":16,"publisher":"Sociedade Portuguesa de Reumatologia","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARP Rheumatol"],"abstract":"<jats:p>Objectives: We aimed to identify clinical and serological predictors of myositis in mixed connective tissue disease  (MCTD).  Methods: We performed a nationwide, retrospective, multicentre study including adult-onset MCTD patients  fulfilling at least one of the following diagnostic criteria: Sharp\u2019s, Kasukawa, Alarc\u00f3n-Segovia, or Kahn\u2019s. Univariable  analysis was performed using Chi-square, Fisher exact, Student\u2019s t or Mann-Whitney U tests, as appropriate.  Multivariable analysis was performed using binary logistic regression. Results: Ninety-eight patients were included. Myositis was observed in 43.9% of patients, of whom 60.5% had  myositis at disease onset.  Proximal muscle weakness was described in 30 patients with muscle involvement (70%). Gastrointestinal  involvement was identified in 28% and respiratory involvement in 29% of myositis patients. In the same subgroup  of patients, 41.7% had a myopathic pattern on electromyography, and 47.1% had histological myositis features in  the muscle biopsy.  Fever (OR=6.96, p=0.022) was an independent predictor of myositis, regardless of sex, age at diagnosis, ancestry,  and respiratory involvement. African ancestry (OR=8.39, p=0.019), leukopenia at the disease onset (OR 6.24,  p=0.021), and younger age at diagnosis (OR=1.07\/year, p=0.035) were identified as independent predictors of  myositis at disease onset, regardless of sex and scleroderma pattern in capillaroscopy. Conclusions: Myositis is a common manifestation of MCTD, even at the disease onset. African ancestry, leukopenia  at the disease onset, younger age at diagnosis, and fever should prompt a thorough evaluation for myositis.<\/jats:p>","DOI":"10.63032\/bayu2491","type":"journal-article","created":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T18:35:14Z","timestamp":1728153314000},"page":"174-181","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of myositis in mixed connective tissue disease: a multicentre retrospective study"],"prefix":"10.63032","volume":"3","author":[{"name":"Rheumatology Unit, Centro Hospitalar Universit\u00e1rio Lisboa Central,  Lisbon, Portugal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AT","family":"Melo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Silv\u00e9rio-Ant\u00f3nio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar  Universit\u00e1rio Lisboa Norte, Centro Acad\u00e9mico de Medicina de  Lisboa, Lisbon, Portugal; 3Rheumatology Research Unit, Instituto  de Medicina Molecular, Faculdade de Medicina, Universidade de  Lisboa, Centro Acad\u00e9mico de Medicina de Lisboa, Lisbon, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Martins-Martinho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar  Universit\u00e1rio Lisboa Norte, Centro Acad\u00e9mico de Medicina de  Lisboa, Lisbon, Portugal; 3Rheumatology Research Unit, Instituto  de Medicina Molecular, Faculdade de Medicina, Universidade de  Lisboa, Centro Acad\u00e9mico de Medicina de Lisboa, Lisbon, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Guimar\u00e3es","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Unidade Local de Sa\u00fade do Alto  Minho, Ponte de Lima, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Dourado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal; Aveiro  Rheumatology Research Center, Egas Moniz Health Alliance,  Aveiro, Portuga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine,  University of Porto, Porto, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department,  Hospital Garcia de Orta, Lisboa, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Saraiva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology  Department, Centro Hospitalar Universit\u00e1rio de Coimbra, Coimbra, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Gago","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar Lisboa  Ocidental, Lisbon, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Correia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Hospital  de Braga, Braga, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AL","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro  Hospitalar Universit\u00e1rio do Algarve, Faro, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Dinis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology  Department, Unidade Local de Sa\u00fade da Guarda, Guarda, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SP","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department,  Centro Hospitalar do Baixo Vouga, Aveiro, Portugal; Aveiro  Rheumatology Research Center, Egas Moniz Health Alliance,  Aveiro, Portuga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar  Tr\u00e1s-os-Montes e Alto Douro, Vila Real, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Beir\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology  Department, Centro Hospitalar Vila Nova de Gaia\/Espinho, Gaia,  Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Furtado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Hospital do Divino Esp\u00edrito  Santo, Ponta Delgada, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Abreu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Unit, Unidade  Local de Sa\u00fade de Castelo Branco, Castelo Branco, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Khmelinskii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Rheumatology Department, Centro Hospitalar  Universit\u00e1rio Lisboa Norte, Centro Acad\u00e9mico de Medicina de  Lisboa, Lisbon, Portugal; Rheumatology Research Unit, Instituto  de Medicina Molecular, Faculdade de Medicina, Universidade de  Lisboa, Centro Acad\u00e9mico de Medicina de Lisboa, Lisbon, Portugal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"49459","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"9692030","DOI":"10.1155\/2020\/9692030","article-title":"Clinical and Immunological Profile of Mixed Connective Tissue Disease and a Comparison of Four Diagnostic Criteria","volume":"2020","author":"John","year":"2020","unstructured":"1. John KJ, Sadiq M, George T, Gunasekaran K, Francis N, Rajadurai E, et al. Clinical and Immunological Profile of Mixed Connective Tissue Disease and a Comparison of Four Diagnostic Criteria. Int J Rheumatol. 2020;2020:9692030.","journal-title":"Int J Rheumatol"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Cappelli S, Bellando Randone S, Martinovi\u0107 D, Tamas MM, Pasali\u0107 K, Allanore Y, et al. \u00abTo be or not to be,\u00bb ten years after: evidence for mixed connective tissue disease as a distinct entity. Semin Arthritis Rheum. fevereiro de 2012;41(4):589-98.","DOI":"10.1016\/j.semarthrit.2011.07.010"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. Lundberg IE. The prognosis of mixed connective tissue disease. Rheum Dis Clin North Am. agosto de 2005;31(3):535-47, vii-viii.","DOI":"10.1016\/j.rdc.2005.04.005"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. Hajas A, Szodoray P, Nakken B, Gaal J, Z\u00f6ld E, Laczik R, et al. Clinical course, prognosis, and causes of death in mixed connective tissue disease. J Rheumatol. julho de 2013;40(7):1134-42.","DOI":"10.3899\/jrheum.121272"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. Aringer M, Smolen JS. Mixed connective tissue disease: what is behind the curtain? Best Pract Res Clin Rheumatol. dezembro de 2007;21(6):1037-49.","DOI":"10.1016\/j.berh.2007.10.002"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. Gunnarsson R, Hetlevik SO, Lilleby V, Molberg \u00d8. Mixed connective tissue disease. Best Pract Res Clin Rheumatol. fevereiro de 2016;30(1):95-111.","DOI":"10.1016\/j.berh.2016.03.002"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. Hall S, Hanrahan P. Muscle involvement in mixed connective tissue disease. Rheum Dis Clin North Am. agosto de 2005;31(3):509-17, vii.","DOI":"10.1016\/j.rdc.2005.04.003"},{"issue":"9","key":"ref7","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1191\/0961203305lu2205oa","article-title":"Cardiac involvement in autoimmune myositis and mixed connective tissue disease","volume":"14","author":"Lundberg","year":"2005","unstructured":"8. Lundberg IE. Cardiac involvement in autoimmune myositis and mixed connective tissue disease. Lupus. 2005;14(9):708-12.","journal-title":"Lupus"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. Bottai M, Tj\u00e4rnlund A, Santoni G, Werth VP, Pilkington C, Visser M de, et al. EULAR\/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a methodology report. RMD Open. 1 de novembro de 2017;3(2):e000507.","DOI":"10.1136\/rmdopen-2017-000507"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. Zahr ZA, Baer AN. Malignancy in myositis. Curr Rheumatol Rep. junho de 2011;13(3):208-15.","DOI":"10.1007\/s11926-011-0169-7"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11. Szodoray P, Hajas A, Kardos L, Dezso B, Soos G, Zold E, et al. Distinct phenotypes in mixed connective tissue disease: subgroups and survival. Lupus. novembro de 2012;21(13):1412-22.","DOI":"10.1177\/0961203312456751"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12. Brewster LM, Coronel CMD, Sluiter W, Clark JF, van Montfrans GA. Ethnic differences in tissue creatine kinase activity: an observational study. PloS One. 2012;7(3):e32471.","DOI":"10.1371\/journal.pone.0032471"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13. Paik JJ, Wigley FM, Mejia AF, Hummers LK. Independent Association of Severity of Muscle Weakness With Disability as Measured by the Health Assessment Questionnaire Disability Index in Scleroderma. Arthritis Care Res. novembro de 2016;68(11):1695-703.","DOI":"10.1002\/acr.22870"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14. Tiniakou E, Goldman D, Corse A, Mammen A, Petri MA. Clinical and histopathological features of myositis in systemic lupus erythematosus. Lupus Sci Med. mar\u00e7o de 2022;9(1):e000635.","DOI":"10.1136\/lupus-2021-000635"},{"issue":"3","key":"ref14","doi-asserted-by":"publisher","first-page":"217","DOI":"10.3109\/03009742.2013.868512","article-title":"Myopathy is a poor prognostic feature in systemic sclerosis: results from the Canadian Scleroderma Research Group (CSRG) cohort","volume":"43","author":"Jung","year":"2014","unstructured":"15. Jung M, Bonner A, Hudson M, Baron M, Pope JE, Canadian Scleroderma Research Group (CSRG). Myopathy is a poor prognostic feature in systemic sclerosis: results from the Canadian Scleroderma Research Group (CSRG) cohort. Scand J Rheumatol. 2014;43(3):217-20.","journal-title":"Scand J Rheumatol"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"16. Liang Y, Leng RX, Pan HF, Ye DQ. Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study. Med Sci Monit Int Med J Exp Clin Res. 26 de maio de 2017;23:2543-9.","DOI":"10.12659\/MSM.902016"}],"container-title":["ARP Rheumatology"],"original-title":[],"deposited":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T20:41:13Z","timestamp":1728160873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.arprheumatology.com\/section.php?id=1703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,9,30]]}},"URL":"https:\/\/doi.org\/10.63032\/bayu2491","relation":{},"ISSN":["2795-4552","2795-4552"],"issn-type":[{"type":"print","value":"2795-4552"},{"type":"electronic","value":"2795-4552"}],"subject":[],"published":{"date-parts":[[2024,9,30]]}}}