Analysis of metabolic syndrome in adult dermatomyositis with a focus on cardiovascular disease.

OBJECTIVE: To evaluate the frequency of metabolic syndrome in dermatomyositis (DM) patients and to analyze the possible association of metabolic syndrome with traditional cardiovascular disease (CVD) risk factors and DM-related clinical and laboratory features. METHODS: The present cross-sectional single-center study included 84 DM patients and 105 healthy controls. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III. RESULTS: The median age was similar in both the DM and control groups (41.5 and 42.0 years, respectively; P = 0.378), with a comparable predominance of women (P = 0.904) and white race (P = 0.623). The DM patients had a higher prevalence of metabolic syndrome (41.7% versus 7.0%; P < 0.001), diabetes mellitus (17.9% versus 1.0%; P < 0.001), stroke (4.8% versus 0%; P = 0.024), and family history of CVD (23.8% versus 8.6%; P = 0.004). However, the frequency of sedentarism, hypothyroidism, smoking, and alcohol intake was similar in both groups (P > 0.05). Further analysis of the DM patients with (n = 35) and without (n = 49) metabolic syndrome revealed that the patients with this complication were older (mean ± SD age 50.0 ± 14.5 years versus 40.9 ± 14.6 years; P = 0.006) and had a similar disease duration (P = 0.925) and higher prevalence of systemic arterial hypertension prior to the onset of disease symptoms (54.3% versus 10.2%; P < 0.001). In a multivariate analysis, only hypertension diagnosed prior to the disease was associated with metabolic syndrome (odds ratio 10.47 [95% confidence interval 2.62-44.81]). CONCLUSION: Metabolic syndrome is highly prevalent in DM, and prior hypertension seems to be a major determinant of its development, while disease- and therapy-related factors do not appear to play a relevant role.

[Autoimmune hepatitis and dermatomyositis: a rare association]. / Hepatite autoimune e dermatomiosite: uma rara associação.

The association between autoimmune hepatitis and idiopathic inflammatory myopathies has been rarely described in literature. To our knowledge, there are only five reports of autoimmune hepatitis, all coursing with polymyositis. In the present work, we describe a female patient at the age of 58 with cutaneous lesions (heliotrope), progressive proximal muscle weakness of four limbs and constitutional symptoms for 12 months, and worsened two months ago. She had also been episodes of jaundice for five months. During hospitalization, after intense clinical investigation, the diagnosis of dermatomyositis and autoimmune hepatitis were defined, and the patient had a good clinical and laboratory response to corticosteroids and immunosuppressive.