Description

Oldroyd et al reported criteria for when to screen a patient with idiopathic inflammatory myopathy for underlying cancer. The authors are from multiple institutions in the United States and Europe.


Patient selection: idiopathic inflammatory myopathy

 

High risk factors:

(1) dermatomyositis

(2) anti-TIF1

(3) anti-NXP2

(4) age > 40 years at myositis onset

(5) persistent high disease activity despite immunosuppressive therapy

(6) moderate to severe dysphagia

(7) cutaneous necrosis

 

Intermediate risk factors:

(1) clinically amyopathic dermatomyositis

(2) polymyositis

(3) immune-mediated necrotising myopathy IMNM

(4) anti-SAE1

(5) anti-HMGCR

(6) anti-Mi2

(7) anti-MDA5

(8) male sex

 

Low risk factors:

(1) antisynthetase syndrome

(2) overlap of idiopathic inflammatory myositis and connective tissue disease-associated myositis

(3) anti-SRP

(4) anti-Jo1

(5) non-Jo1 ASS (argininosuccinate synthetase) antibody positivity

(6) myositis-associated antibody positivity (PM-Sci, Ku, RNP, Ro/La)

(7) Raynaud's

(8) inflammatory arthropathy

(9) interstitial lung disease

 

If the patient has >= 2 high risk factors, then high risk.

If the patient has 1 high risk factor OR >= 2 intermediate risk factors, then intermediate risk.

If neither rule applies, then low risk.


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