A New Method for the Assessment of Myalgia in Interstitial Lung Disease: Association with Positivity for Myositis-Specific and Myositis-Associated Antibodies
Gianluca Sambataro,
Chiara Alfia Ferrara,
Carla Spadaro,
Sebastiano Emanuele Torrisi,
Giovanna Vignigni,
Ada Vancheri,
Giuseppe Muscato,
Nicoletta Del Papa,
Michele Colaci,
Lorenzo Malatino,
Stefano Palmucci,
Lorenzo Cavagna,
Giovanni Zanframundo,
Francesco Ferro,
Chiara Baldini,
Domenico Sambataro,
Carlo Vancheri
Affiliations
Gianluca Sambataro
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Chiara Alfia Ferrara
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Carla Spadaro
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Sebastiano Emanuele Torrisi
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Giovanna Vignigni
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Ada Vancheri
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Giuseppe Muscato
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
Nicoletta Del Papa
Day Hospital of Rheumatology, Department of Rheumatology, ASST G.Pini-CTO, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
Michele Colaci
Internal Medicine Unit, Department of Clinical and Experimental Medicine, Cannizzaro Hospital, University of Catania, Via Messina 829, 95100 Catania, Italy
Lorenzo Malatino
Internal Medicine Unit, Department of Clinical and Experimental Medicine, Cannizzaro Hospital, University of Catania, Via Messina 829, 95100 Catania, Italy
Stefano Palmucci
Department of Medical, Surgical Sciences and Advanced Technologies, “G.F. Ingrassia”, University of Catania, Via S. Sofia 68 Catania, 95123 Catania, Italy
Lorenzo Cavagna
Division of Rheumatology, University and IRCCS Policlinico S. Matteo, Piazzale C. Golgi 19, 27100 Pavia, Italy
Giovanni Zanframundo
Division of Rheumatology, University and IRCCS Policlinico S. Matteo, Piazzale C. Golgi 19, 27100 Pavia, Italy
Francesco Ferro
Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Via Roma 24, 56126 Pisa, Italy
Chiara Baldini
Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Via Roma 24, 56126 Pisa, Italy
Domenico Sambataro
Outpatient Clinic of Rheumatology, Artroreuma S.R.L., Corso S. Vito 53, 95030 Mascalucia (CT), Italy
Carlo Vancheri
Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, A.O.U. “Policlinico-San Marco”, University of Catania, 95123 Catania, Italy
In this study, it was found that myositis-specific and myositis-associated antibodies (MSAs and MAAs) improved the recognition of idiopathic inflammatory myopathies (IIMs) in interstitial lung disease (ILD) patients. The objective of this study is to propose a clinical method to evaluate myalgia in respiratory settings as a possible tool for the recognition of MSA/MAA positivity in ILD patients. We prospectively enrolled 167 ILD patients with suspected myositis, of which 63 had myalgia evoked at specific points (M+ILD+). We also enrolled in a 174 patients with only myalgia (M+ILD-) in a rheumatological setting. The patients were assessed jointly by rheumatologists and pulmonologists and were tested for autoantibodies. M+ILD+ patients were positive for at least one MAA/MSA in 68.3% of cases, as were M-ILD+ patients in 48.1% of cases and M+ILD- patients in 17.2% of cases (p = 0.01 and p = 0.02). Myalgia was significantly associated with positivity for MSA/MAAs in ILD patients (p = 0.01, X2: 6.47). In conclusion, myalgia in ILD patients with suspected myositis is associated with MSA/MAA positivity, and could support a diagnosis of IIM. A significant proportion of M+ILD- patients also had MSA/MAA positivity, a phenomenon warranting further study to evaluate its clinical meaning.
