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. 2018 Jun;57(6):927-931.
doi: 10.1002/mus.26032. Epub 2017 Dec 20.

Infections and the relationship to treatment in neuromuscular autoimmunity

Devin E Prior  1 , Emily Nurre  1 , Stephanie L Roller  1 , David Kline  2 , Ramit Panara  1 , Amro M Stino  1 , John A Davis  3 , Miriam L Freimer  1   4 , W David Arnold  1   4   5
Affiliations

Infections and the relationship to treatment in neuromuscular autoimmunity

Devin E Prior et al. Muscle Nerve. 2018 Jun.

Abstract

Introduction: This study aimed to identify infections in patients with myasthenia gravis, dermatomyositis, and chronic inflammatory demyelinating polyradiculoneuropathy, and to investigate the relationship between infection and immunomodulation.

Methods: A retrospective chart review examined 631 patients with myasthenia gravis (n = 358), chronic inflammatory demyelinating polyradiculoneuropathy (n = 124), and dermatomyositis (n = 149) patients over a 10-year time period.

Results: Infection rates were similar at approximately 19% in all 3 diseases. Of the infections in which a causative organism was identified, pneumonia, sepsis, and opportunistic infections were the leading diagnoses. A multivariate model demonstrated a significant association between infection and an increased dose of plasma exchange, mycophenolate mofetil, and corticosteroid therapy.

Discussion: There are few large studies investigating rates of infections in patients with autoimmune neuromuscular disorders and the relationship to immunomodulation. This study not only demonstrates the remarkably similar infection rates across the 3 diseases studied, but also shows their relationship to commonly used immunotherapies. Muscle Nerve 57: 927-931, 2018.

Keywords: chronic inflammatory demyelinating polyradiculoneuropathy; dermatomyositis; immunosuppression; infection; myasthenia gravis.

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Conflict of interest statement

Disclosure of Conflicts of Interest: None of the authors has any conflict of interest to disclose.

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