Juvenile dermatomyositis: advances in clinical presentation, myositis-specific antibodies and treatment

World J Pediatr. 2020 Feb;16(1):31-43. doi: 10.1007/s12519-019-00313-8. Epub 2019 Sep 26.

Abstract

Background: Juvenile dermatomyositis (JDM) is a chronic autoimmune disease characteristic by inflammation of small vessels within the skin, muscle and vital organs. But the clinical features and treatment of JDM have not been fully clarified.

Data sources: Databases underwent through PubMed for articles about the clinical features, myositis-specific antibodies of JDM and its treatment, and we selected publications written in English which were relevant to the topic of this review.

Results: Clinical features and myositis-specific antibodies may predict the severity and prognosis of disease. Although the mortality rate has been lower with traditional treatments, such as corticosteroid, intravenous immunoglobulin, and disease-modifying anti-rheumatic drugs such as methotrexate, their usages are variable. Novel biological therapies seem to be effective for refractory JDM patients, but more clinical trials are necessary.

Conclusions: JDM is a sever disease of childhood. We need to better understand recent advances of JDM in the context of clinical features including skin manifestations, muscle weakness and organ damage, myositis-specific antibodies and their associated outcomes and the treatment of disease.

Keywords: Biologic agents; Extramuscular manifestations; Juvenile dermatomyositis; Myositis autoantibodies.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Autoantibodies / immunology
  • Biological Products / therapeutic use*
  • Child
  • Dermatomyositis / diagnosis*
  • Dermatomyositis / drug therapy*
  • Dermatomyositis / immunology*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Prognosis

Substances

  • Adrenal Cortex Hormones
  • Antirheumatic Agents
  • Autoantibodies
  • Biological Products
  • Immunoglobulins, Intravenous