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Dysphonia and dysphagia as early manifestations of autoimmune inflammatory myopathy
While dysphagia is a recognized manifestation of autoimmune inflammatory myopathy, a relationship between myositis and dysphonia or laryngeal pathology is not well-documented. We therefore sought to describe the spectrum of laryngeal disorders present in myositis patients, evaluate whether any speci...
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| Published in: | American journal of otolaryngology 2021-01, Vol.42 (1), p.102747-102747, Article 102747 |
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| creator | Weinreb, Samuel F. Piersiala, Krzysztof Hillel, Alexander T. Akst, Lee M. Best, Simon R. |
| description | While dysphagia is a recognized manifestation of autoimmune inflammatory myopathy, a relationship between myositis and dysphonia or laryngeal pathology is not well-documented. We therefore sought to describe the spectrum of laryngeal disorders present in myositis patients, evaluate whether any specific conditions are overrepresented among these patients compared to a large treatment-seeking population, and examine the clinical course and outcomes of these symptoms.
This was a retrospective chart review, including all patients seen at the Johns Hopkins Voice Center between January 2016 and December 2017. Demographic data, comorbidities, and laryngeal diagnoses were extracted from the electronic medical record. The charts of patients with myositis were reviewed further to ascertain details of their laryngeal symptoms and myositis disease course. Associations between myositis and dysphonia/dysphagia were evaluated using binary regression and multinomial logistic regression models to adjust for age, sex, race, and smoking status.
Of 4252 patients, sixteen had myositis. Compared to 4236 controls, these patients had significantly higher odds of presenting with muscular voice disorders (adjusted odds ratio (OR*) = 4.503, p* = 0.005) and dysphagia (OR* = 6.823, p* |
| doi_str_mv | 10.1016/j.amjoto.2020.102747 |
| format | article |
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This was a retrospective chart review, including all patients seen at the Johns Hopkins Voice Center between January 2016 and December 2017. Demographic data, comorbidities, and laryngeal diagnoses were extracted from the electronic medical record. The charts of patients with myositis were reviewed further to ascertain details of their laryngeal symptoms and myositis disease course. Associations between myositis and dysphonia/dysphagia were evaluated using binary regression and multinomial logistic regression models to adjust for age, sex, race, and smoking status.
Of 4252 patients, sixteen had myositis. Compared to 4236 controls, these patients had significantly higher odds of presenting with muscular voice disorders (adjusted odds ratio (OR*) = 4.503, p* = 0.005) and dysphagia (OR* = 6.823, p* < 0.001). A majority (64.3%, CI:35.6–93.0%) of myositis patients had laryngeal pathology among the presenting symptoms of their myositis. Across all diagnostic categories, there was a non-significant trend towards better outcomes in patients receiving specific interventions for their laryngeal symptoms.
Muscular voice disorders and dysphagia are significantly overrepresented in myositis patients presenting to a laryngology clinic, and in these patients, both are frequently among the presenting symptoms of myositis.
•Muscular voice disorders and dysphagia are associated with myositis.•Voice and swallowing disorders may be among the presenting symptoms of myositis.•In a subset of patients, these symptoms do not improve with immunosuppression alone.•Recognition of laryngeal manifestations may allow earlier diagnosis of myositis.</description><identifier>ISSN: 0196-0709</identifier><identifier>ISSN: 1532-818X</identifier><identifier>EISSN: 1532-818X</identifier><identifier>DOI: 10.1016/j.amjoto.2020.102747</identifier><identifier>PMID: 33038783</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Age Factors ; Autoimmune Diseases - complications ; Autoimmune Diseases - diagnosis ; Deglutition disorders ; Deglutition Disorders - epidemiology ; Deglutition Disorders - etiology ; Dermatomyositis ; Diagnostic systems ; Disorders ; Dysphagia ; Dysphonia ; Dysphonia - epidemiology ; Dysphonia - etiology ; Early Diagnosis ; Electronic health records ; Electronic medical records ; Evaluation ; Female ; Humans ; Inflammation ; Inflammatory diseases ; Male ; Medical records ; Medicin och hälsovetenskap ; Middle Aged ; Musculoskeletal diseases ; Myopathy ; Myositis ; Myositis - complications ; Myositis - diagnosis ; Ostomy ; Pathology ; Patients ; Polymyositis ; Quality of Life ; Regression analysis ; Regression models ; Retrospective Studies ; Sex Factors ; Signs and symptoms ; Smoking ; Velopharyngeal insufficiency ; Voice</subject><ispartof>American journal of otolaryngology, 2021-01, Vol.42 (1), p.102747-102747, Article 102747</ispartof><rights>2020</rights><rights>Copyright © 2020. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Jan 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c579t-43bdfab155f121b4e71c37f57e7216025033c9691fbdb2c407f51dd97651dff83</citedby><cites>FETCH-LOGICAL-c579t-43bdfab155f121b4e71c37f57e7216025033c9691fbdb2c407f51dd97651dff83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33038783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:145400605$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Weinreb, Samuel F.</creatorcontrib><creatorcontrib>Piersiala, Krzysztof</creatorcontrib><creatorcontrib>Hillel, Alexander T.</creatorcontrib><creatorcontrib>Akst, Lee M.</creatorcontrib><creatorcontrib>Best, Simon R.</creatorcontrib><title>Dysphonia and dysphagia as early manifestations of autoimmune inflammatory myopathy</title><title>American journal of otolaryngology</title><addtitle>Am J Otolaryngol</addtitle><description>While dysphagia is a recognized manifestation of autoimmune inflammatory myopathy, a relationship between myositis and dysphonia or laryngeal pathology is not well-documented. We therefore sought to describe the spectrum of laryngeal disorders present in myositis patients, evaluate whether any specific conditions are overrepresented among these patients compared to a large treatment-seeking population, and examine the clinical course and outcomes of these symptoms.
This was a retrospective chart review, including all patients seen at the Johns Hopkins Voice Center between January 2016 and December 2017. Demographic data, comorbidities, and laryngeal diagnoses were extracted from the electronic medical record. The charts of patients with myositis were reviewed further to ascertain details of their laryngeal symptoms and myositis disease course. Associations between myositis and dysphonia/dysphagia were evaluated using binary regression and multinomial logistic regression models to adjust for age, sex, race, and smoking status.
Of 4252 patients, sixteen had myositis. Compared to 4236 controls, these patients had significantly higher odds of presenting with muscular voice disorders (adjusted odds ratio (OR*) = 4.503, p* = 0.005) and dysphagia (OR* = 6.823, p* < 0.001). A majority (64.3%, CI:35.6–93.0%) of myositis patients had laryngeal pathology among the presenting symptoms of their myositis. Across all diagnostic categories, there was a non-significant trend towards better outcomes in patients receiving specific interventions for their laryngeal symptoms.
Muscular voice disorders and dysphagia are significantly overrepresented in myositis patients presenting to a laryngology clinic, and in these patients, both are frequently among the presenting symptoms of myositis.
•Muscular voice disorders and dysphagia are associated with myositis.•Voice and swallowing disorders may be among the presenting symptoms of myositis.•In a subset of patients, these symptoms do not improve with immunosuppression alone.•Recognition of laryngeal manifestations may allow earlier diagnosis of myositis.</description><subject>Age</subject><subject>Age Factors</subject><subject>Autoimmune Diseases - complications</subject><subject>Autoimmune Diseases - diagnosis</subject><subject>Deglutition disorders</subject><subject>Deglutition Disorders - epidemiology</subject><subject>Deglutition Disorders - etiology</subject><subject>Dermatomyositis</subject><subject>Diagnostic systems</subject><subject>Disorders</subject><subject>Dysphagia</subject><subject>Dysphonia</subject><subject>Dysphonia - epidemiology</subject><subject>Dysphonia - etiology</subject><subject>Early Diagnosis</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inflammatory diseases</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Musculoskeletal diseases</subject><subject>Myopathy</subject><subject>Myositis</subject><subject>Myositis - complications</subject><subject>Myositis - diagnosis</subject><subject>Ostomy</subject><subject>Pathology</subject><subject>Patients</subject><subject>Polymyositis</subject><subject>Quality of Life</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Signs and symptoms</subject><subject>Smoking</subject><subject>Velopharyngeal insufficiency</subject><subject>Voice</subject><issn>0196-0709</issn><issn>1532-818X</issn><issn>1532-818X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9Ustu1TAQtRCIXgp_gFAkNmxy8dvxBgm15SFVYgFI7CwnsXsdEjvYSVH-vo5y21IkWI1n5pxjz_gA8BLBPYKIv-32eujCFPYY4rWEBRWPwA4xgssKVT8egx1EkpdQQHkCnqXUQQgJJewpOCEEkkpUZAe-ni9pPATvdKF9W7Rrpq_WLBVGx34pBu2dNWnSkws-FcEWep6CG4bZm8J52-th0FOIGbmEUU-H5Tl4YnWfzItjPAXfP1x8O_tUXn75-Pns_WXZMCGnkpK6tbpGjFmEUU2NQA0RlgkjMOIQM0hII7lEtm5r3FCYe6htpeA5WFuRU1Buuum3GedajdENOi4qaKeOpZ_5ZBTlgvIVL_-JH2No70m3REQZhZBDlrnvNm4GDKZtjJ-i7h9KPOh4d1BX4VoJgTGUJAu8OQrE8GvO-1SDS43pe-1NmJPClErJKkJxhr7-C9qFOfq8yoziHHNUsVWQbqgmhpSisXePQVCtDlGd2hyiVoeozSGZ9urPQe5It5a4n9Tkr7t2JqrUOOMb07pomkm1wf3_hhvJQtGu</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Weinreb, Samuel F.</creator><creator>Piersiala, Krzysztof</creator><creator>Hillel, Alexander T.</creator><creator>Akst, Lee M.</creator><creator>Best, Simon R.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20210101</creationdate><title>Dysphonia and dysphagia as early manifestations of autoimmune inflammatory myopathy</title><author>Weinreb, Samuel F. ; 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We therefore sought to describe the spectrum of laryngeal disorders present in myositis patients, evaluate whether any specific conditions are overrepresented among these patients compared to a large treatment-seeking population, and examine the clinical course and outcomes of these symptoms.
This was a retrospective chart review, including all patients seen at the Johns Hopkins Voice Center between January 2016 and December 2017. Demographic data, comorbidities, and laryngeal diagnoses were extracted from the electronic medical record. The charts of patients with myositis were reviewed further to ascertain details of their laryngeal symptoms and myositis disease course. Associations between myositis and dysphonia/dysphagia were evaluated using binary regression and multinomial logistic regression models to adjust for age, sex, race, and smoking status.
Of 4252 patients, sixteen had myositis. Compared to 4236 controls, these patients had significantly higher odds of presenting with muscular voice disorders (adjusted odds ratio (OR*) = 4.503, p* = 0.005) and dysphagia (OR* = 6.823, p* < 0.001). A majority (64.3%, CI:35.6–93.0%) of myositis patients had laryngeal pathology among the presenting symptoms of their myositis. Across all diagnostic categories, there was a non-significant trend towards better outcomes in patients receiving specific interventions for their laryngeal symptoms.
Muscular voice disorders and dysphagia are significantly overrepresented in myositis patients presenting to a laryngology clinic, and in these patients, both are frequently among the presenting symptoms of myositis.
•Muscular voice disorders and dysphagia are associated with myositis.•Voice and swallowing disorders may be among the presenting symptoms of myositis.•In a subset of patients, these symptoms do not improve with immunosuppression alone.•Recognition of laryngeal manifestations may allow earlier diagnosis of myositis.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33038783</pmid><doi>10.1016/j.amjoto.2020.102747</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Age Factors Autoimmune Diseases - complications Autoimmune Diseases - diagnosis Deglutition disorders Deglutition Disorders - epidemiology Deglutition Disorders - etiology Dermatomyositis Diagnostic systems Disorders Dysphagia Dysphonia Dysphonia - epidemiology Dysphonia - etiology Early Diagnosis Electronic health records Electronic medical records Evaluation Female Humans Inflammation Inflammatory diseases Male Medical records Medicin och hälsovetenskap Middle Aged Musculoskeletal diseases Myopathy Myositis Myositis - complications Myositis - diagnosis Ostomy Pathology Patients Polymyositis Quality of Life Regression analysis Regression models Retrospective Studies Sex Factors Signs and symptoms Smoking Velopharyngeal insufficiency Voice |
| title | Dysphonia and dysphagia as early manifestations of autoimmune inflammatory myopathy |
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