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Journal of Neurology

, Volume 266, Issue 6, pp 1358–1366 | Cite as

Evaluating the diagnostic utility of new line immunoassays for myositis antibodies in clinical practice: a retrospective study

  • Federica MontagneseEmail author
  • Haris Babačić
  • Peter Eichhorn
  • Benedikt Schoser
Original Communication
  • 193 Downloads

Abstract

Background

Myositis-associated antibodies (MAA) and myositis-specific antibodies (MSA) are detected in patients with idiopathic inflammatory myopathies (IIM); their role as diagnostic biomarkers is however still debated. The aim of our study was to assess the utility of MAA/MSA assessed by new line immunoassays in detecting myositis among neuromuscular patients.

Methods

We retrospectively analysed sera samples obtained from patients tested for myositis antibodies with the “Euroline: Autoimmune Inflammatory Myopathies 16Ag” and “myositis profile 3” kits (Mi-2, TIF1γ, MDA5, NXP2, SAE1, Jo-1, SRP, PL-7/12, EJ, OJ, Ro-52, Ku, PM-Scl75/100). First symptom, CK, EMG, muscle biopsy and diagnosis were also analysed. Using logistic regression analysis, two diagnostic models were built to evaluate the diagnostic power of MAA/MSA in distinguishing myositis patients from controls and other myopathies.

Results

1229 patients were identified. 141 patients had a bioptic confirmed IIM; other diagnoses included: myopathy (n = 357), other neuromuscular diseases (n = 144) and no neuromuscular diseases (n = 587). The specificity was 95% for MSA and 89% for MAA, the sensitivity 20% and 22%, respectively. MAA showed no use in differentiating myositis patients from controls, whereas MSA had limited effect (OR = 5.165), compared to other variables as EMG (OR = 47.755) or CK > 2000 U/L (OR = 45.307). MSA were, however, the most useful parameter differentiating IIM from non-IIM patients (OR = 7.259), better than CK > 2000 U/L (OR = 4.033) and MAA (OR = 2.737).

Conclusions

Line immunoassays for myositis antibodies show high specificity but low sensitivity. Their usefulness as diagnostic biomarkers widely depends on the clinical settings. Our study suggests that MSA/MAA should be used for confirmatory and differential diagnosis rather than for screening purposes in inflammatory myopathies.

Keywords

Idiopathic inflammatory myopathies Myositis Antibodies Diagnosis 

Notes

Funding

None.

Compliance with ethical standards

Conflicts of interest

All authors declare they have no conflict of interest to disclose.

Ethical standards

The study has been conducted in compliance with the principles of the declaration of Helsinki and with the local German laws and regulations.

Supplementary material

415_2019_9266_MOESM1_ESM.docx (30 kb)
Supplementary material 1 (DOCX 30 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurology, Friedrich-Baur-InstituteLudwig-Maximilians-University MunichMunichGermany
  2. 2.Institute of Laboratory MedicineUniversity Hospital, LMU MunichMunichGermany

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