Background/Purpose: Calcinosis is known to be associated with junvenile dermatomyositis, but the prevalence and risk factors associated with the development of calcinosis in adult dermatomyositis (DM) patients is unknown.  We sought to quantify this burden by estimating the prevalence of calcinosis by patient self- report, and identifying associated risk factors for calcinosis in adult DM patients. 

Methods: After obtaining IRB approval, a standardized telephone interview and retrospective chart review of 50 consecutive adult DM patients evaluated between 5/1/97 and 1/1/13 at a single tertiary care center was conducted.  Variables collected included: self-reported anatomic location of calcinosis if present; laboratory data including myositis specific antibodies (MSAs); signs and symptoms of dermatomyositis; calcinosis treatment history; and immunosuppressant agents used.  Patients were separated into 2 groups – those who developed calcinosis over the course of their disease and those who did not. 

Results: Of the 50 patients, 76% were female, 19 (38%) developed calcinosis over their disease course (89% of whom were female), and 84% had at least one positive MSA.  MDA5 was the only MSA which was significantly associated with calcinosis. The mean time between symptom onset and diagnosis of dermatomyositis was 16 months.  The mean time between the diagnosis of dermatomyositis and development of calcinosis was 21 months.  Patients with calcinosis scored lower on the SF-36v2 compared to patients without calcinosis (39.52 vs. 44.17; p=0.055).  Furthermore, patients with calcinosis scored higher (indicating a higher degree of difficulty performing activities of daily living) compared to patients without calcinosis (0.93 vs. 0.69; p=0.096) on the Stanford Health Assessment Questionnaire Disability Scale (HAQ).  Calcinosis patients also reported worse joint pain (4.0 vs. 3.06 on a 10 point scale). 

Conclusion: Calcinosis is a common complication of adult dermatomyositis patients.  Calcinosis risk factors included the specific MSA, MDA5.  Patients with calcinosis have more difficulty performing activities of daily living, experience more joint pain, and rate their physical health worse than patients who do not have calcinosis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/defining-the-prevalence-and-associated-risk-factors-for-calcinosis-in-adult-dermatomyositis-patients/