Study on the clinical features and peripheral blood lymphocyte subsets of clinically amyopathic dermatomyositis

LIU Yi-xuan; SUN Hong-sheng; WANG Zhan-kui; WANG Xiao-dong; HOU Yan-feng

doi:10.19538/j.nk2023120110

Abstract：Objective To analyze the clinical features and distribution of lymphocyte subsets in peripheral blood of clinically amyopathic dermatomyositis(CADM).Methods A retrospective analysis was conducted on the clinical data of 49 patients with CADM and 60 patients with classic dermatomyositis(DM)admitted totthe First Affiliated Hospital of Shandong First Medical University from January 2020 to January 2023.Compare the clinical clata lymphocyte subpopulation count and percentage among two groups of patients;multivariate logistic regression analysis was used to analyze independent risk factors for CADM.The CADM patients were divided into CADM group with mechanic's hands(17 cases)and CADM group without mechanic's hands(32 cases);and they were divided into group of CADM with anti-melanoma differentiation-associated gene 5 antibody positive group(26 cases)and group of CADM with anti-aminoacyl-tRNA synthetase antibody positive group(18 cases);the number and percentage of lymphocyte subsets in subgroups were compared.Results The rapidly progressive ILD(RP-ILD),Gottron sign,mechanic's hands,anti MDA5 antibody,and CEA in the CADM group were higher than those in the DM group.While the V shawl neck sign,the cape sign,CK and CK-MB in the CADM group were lower than those in the DM group,with significant differences(P＜0.05).The cell counts of CD3+,CD3+CD4+,CD3+CD8+,CD3-CD16/56+,CD3+CD16/56+and CD4+CD25+and the percentage of CD3-CD 16/56+and CD4+CD25+cells in CADM patients were significantly lower than those in DM patients,while the percentage of CD3-CD19+cells in CADM patients was significantly higher than that in DM patients,with significant differences(P＜0.05).CD3-CD19+cell percentage(OR 1.208,95％CI 1.009-1.447,P=0.040)is the independent risk factor for CADM.The percentage of CD3+CD8+cells in CADM patients with mechanic's hands was significantly lower than in patients without mechanic's hands.The percentage of CD3-CD16/56+and the cell counts of CD3+、CD3+CD4+、CD3+CD8+、CD3-CD16/56+、CD3+CD16/56+,and CD4+CD25+in CADM with positive anti-MDA5 antibodies were significantly lower than CADM with positive anti-ARS antibodies(P＜0.05)..Conclusion Compared with DM,CADM has a decrease in T cells,an increase in B cells,and a significant abnormality in lymphocyte subsets,which may be involved in the pathogenesis of CADM.