High-resolution manometry in patients with idiopathic inflammatory myopathy: Elevated prevalence of esophageal involvement and differences according to autoantibody status and clinical subset

Muscle Nerve. 2017 Sep;56(3):386-392. doi: 10.1002/mus.25507. Epub 2017 Apr 4.

Abstract

Introduction: In this study we assessed high-resolution manometry (HRM) findings in patients with dermatomyositis and polymyositis.

Methods: From 2008 to 2015, we performed a cross-sectional study of myositis patients. A survey of esophageal symptoms and HRM data were analyzed and compared among different clinical and serologic groups.

Results: Twenty-four (45%) of the 53 patients included in the study had manometric involvement that was not correlated with any esophageal symptom (P = 0.8). Failed waves (34% vs. 0%, P = 0.004) and decreased upper esophageal sphincter pressure (50 vs. 70 mm Hg, P = 0.03) were more common in polymyositis than in dermatomyositis patients. Jackhammer esophagus was more common in anti-TIF1-γ patients (30% vs. 9%, P = 0.04), and lower esophageal sphincter involvement (47% vs. 25%, P = 0.03) was more prevalent in patients with the antisynthetase syndrome.

Conclusions: Esophageal involvement is common in myositis patients, but it correlates poorly with esophageal symptoms. Specific clinical and serologic groups have different manometric features. Muscle Nerve 56: 386-392, 2017.

Keywords: autoantibodies; dermatomyositis; dysphagia; esophageal involvement; high-resolution manometry; polymyositis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood*
  • Cross-Sectional Studies
  • Esophageal Motility Disorders / blood*
  • Esophageal Motility Disorders / diagnosis
  • Esophageal Motility Disorders / physiopathology*
  • Esophageal Sphincter, Lower / physiopathology
  • Esophagus / physiopathology*
  • Female
  • Humans
  • Male
  • Manometry / methods
  • Middle Aged
  • Myositis / blood*
  • Myositis / diagnosis
  • Myositis / physiopathology*
  • Prevalence

Substances

  • Autoantibodies