A importância dos novos autoanticorpos específicos da dermatomiosite

Joana Calvão; Alexandre Rafael Isidoro Azeiteiro; Margarida Gonçalo

doi:10.29021/spdv.77.1.1021

Joana Calvão Interna de Dermatologia nos Hospitais da Universidade de Coimbra, Coimbra, Portugal
Alexandre Rafael Isidoro Azeiteiro Aluno da Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
Margarida Gonçalo 3Assistente Hospitalar Sénior de Dermatologia nos Hospitais da Universidade de Coimbra, e Professora Auxiliar convidada de Dermatologia da Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal

DOI: https://doi.org/10.29021/spdv.77.1.1021

Abstract

A dermatomiosite é uma miopatia inflamatória idiopática, rara, com manifestações cutâneas e sistémicas variadas. Mais de 70% dos doentes apresentam autoanticorpos específicos da doença, que se correlacionam com manifestações clínicas distintas. Além dos anticorpos anti-sintetase, nos últimos anos foram descobertos vários anticorpos associados à dermatomiosite e que parecem ter um papel importante na orientação diagnóstica e prognóstica da doença, incluindo os autoanticorpos contra melanoma differentiation antigen 5 (MDA5), transcriptional intermediary factor 1 (TIF1), nuclear matrix protein 2 (NXP2), small ubiquitin-like modifier activating enzyme (SAE) e os anti-Mi2. O autoanticorpo anti-MDA5 está associado a dermatomiosite amiopática e doença intersticial pulmonar rapidamente progressiva e potencialmente fatal, além de caraterísticas mucocutâneas distintas, como ulceração cutânea. Há uma forte correlação entre a positividade para os autoanticorpos anti-TIF-1γ e malignidade, pelo menos na dermatomiosite do adulto. Na dermatomiosite juvenil, estes autoanticorpos têm sido associados a doença cutânea mais extensa, mas não a malignidade. A positividade para anti-NXP2 está associada a calcinose cutânea e envolvimento muscular severos. Na dermatomiosite com autoanticorpos anti-SAE há frequentemente envolvimento cutâneo e disfagia severos, mas com boa resposta à terapêutica imunossupressora e bom prognóstico. Os anticorpos anti-Mi2 associam- -se igualmente a um bom prognóstico.

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Author Biography

Margarida Gonçalo, 3Assistente Hospitalar Sénior de Dermatologia nos Hospitais da Universidade de Coimbra, e Professora Auxiliar convidada de Dermatologia da Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal

Assistente Hospitalar Sénior de Dermatologia nos Hospitais da Universidade de Coimbra, e Professora Auxiliar convidada de Dermatologia da Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal

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