High risk of cancer in autoimmune necrotizing myopathies: usefulness of myositis specific antibody

Brain. 2016 Aug;139(Pt 8):2131-5. doi: 10.1093/brain/aww054. Epub 2016 Apr 17.


Cancer can occur in patients with inflammatory myopathies. This association is mainly observed in dermatomyositis, and myositis-specific antibodies have allowed us to delineate patients at an increased risk. Malignancy is also reported in patients with necrotizing autoimmune myopathies, but the risk remains elusive. Anti-signal recognition particle or anti-HMGCR antibodies have been specifically associated with necrotizing autoimmune myopathies. We aimed at screening the incidence of cancer in necrotizing autoimmune myopathies. A group of patients (n = 115) with necrotizing autoimmune myopathies with or without myositis-specific antibodies was analysed. Malignancy occurred more frequently in seronegative necrotizing autoimmune myopathies patients and in HMGCR-positive patients compared to anti-signal recognition particle positive patients. Synchronous malignancy was diagnosed in 21.4% and 11.5% of cases, respectively, and incidence of cancer was higher compared to the general population in both groups. No specific type of cancer was predominant. Patients suffering from a synchronous cancer had a decreased median survival time. Cancer screening is necessary in seronegative necrotizing autoimmune myopathies and in HMGCR-positive patients but not in anti-signal recognition particle-positive patients.

Keywords: auto-antibodies; cancer; necrotizing autoimmune myopathies; polymyositis.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / blood*
  • Autoimmune Diseases / blood*
  • Autoimmune Diseases / epidemiology
  • Comorbidity
  • Dermatomyositis / blood*
  • Dermatomyositis / epidemiology
  • Female
  • Humans
  • Hydroxymethylglutaryl CoA Reductases / immunology*
  • Male
  • Middle Aged
  • Muscular Diseases / blood*
  • Muscular Diseases / epidemiology
  • Myositis / immunology*
  • Neoplasms / blood*
  • Neoplasms / epidemiology


  • Autoantibodies
  • HMGCR protein, human
  • Hydroxymethylglutaryl CoA Reductases