MyoMarker TM Panels Myositis Testing By Doctors For Doctors

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1 MyoMarker TM Panels Myositis Testing By Doctors For Doctors

2 Clinical Expertise Our Medical Directors are board certified Rheumatologists. All of our technologists have over 15 years of experience in immunologic testing and interpretation. RDL has been CAP and CLIA certified since Personal Service Our Medical Directors contact you personally to discuss complex results, and are available for clinical consultation on any of your other test results, as well. Real people answer our phones, so you can get an immediate response to all your questions and concerns. We are a provider for Medicare and Blue Cross/Blue Shield, as well as many other plans throughout the country, and we can usually adapt to your patient s plan. We are sensitive to your patients financial concerns, and can offer unique plans to work within their budget. Cost Effective RDL s panels are more cost-effective than performing individual tests and provide more comprehensive results. RDL offers free courier service throughout the United States. Quick Turnaround A day turnaround on myositis testing enables rapid diagnosis and appropriate therapy for your patients.

3 MyoMarker TM Panels MyoMarker TM myositis testing panels use the most reliable methodologies and, at 10 to 14 days, have the fastest turnaround time in the industry. RDL has created several MyoMarker TM Panels. Our most complete is MyoMarker TM Panel 3, which includes both Myositis-Specific Antibodies (MSA) and Myositis-Associated Antibodies (MAA). For more information on all of our myositis tests, please visit our website, MyoMarker TM Panel 3 Myositis-Specific Antibodies Myositis-Associated Antibodies Anti-Jo-1 Anti-PL-12 Anti-PL-7 Anti-EJ Anti-OJ Anti-SRP Anti-Mi-2 P155/140 P140 Anti-PM/Scl Anti-Ku Anti-SS-A 52 kd, IgG Anti-Fibrillarin U3 RNP Anti-U2 snrnp Anti-U1 RNP Clinical Utility The idiopathic inflammatory myopathies (IIM) are a heterogeneous group of disorders characterized by muscle weakness, resulting from chronic muscle inflammation of unknown cause. Patients with IIM have a variety of autoantibodies with various clinical utilities that fall into two main groups. The first group is found only in patients with Myositis and is known as Myositis Specific Autoantibodies (MSA). The MSAs have been shown to be highly specific for patients with polymyositis (PM), dermatomyositis (DM), anti-synthetase syndrome and overlap syndromes. The second group of antibodies is considered Myositis Associated Autoantibodies (MAA) and can be found in patients with overlap syndromes such as polymyositis/scleroderma. MAA can also be found in non-overlap syndromes.

4 Clinical Associations for Myositis-Specific Antibodies (MSA) Autoantibody Known Associations Anti-Synthetase Antibodies Jo-1 PL-7 EJ PL-12 OJ 15-20% of adult and 5-10% of JM 5-10% of IIM 5-10% of IIM <5% <5% Acute PM, DM or overlap myositis, with high frequency of non-erosive arthritis, interstitial lung disease, fever, mechanic s hand, Raynaud s phenomenon; moderate response to therapy Signal Recognition Particle (SRP) 5-10% of adult and JM Very acute onset of severe PM with frequent myalgias, severe weakness and elevated CPK and/or Aldolase levels; some adults have cardiac involvement and palpitations, more frequently African American females; poor response to therapy Mi % of adults and 5% of JM Classic DM, mild to moderate weakness with shawl sign rashes, heliotrope rash and Gottron's sign; good response to therapy P155/140 kd Newly identified antibody present in 20-30% of CAM in adult DM and JDM patients, including those with DM associated with another connective tissue disease (35%) and cancer-associated DM (71-75%) P140 kd 23% of JDM with Calcinosis; 50% of CADM

5 Clinical Associations for Myositis-Associated Antibodies (MAA) Autoantibody Known Associations PM/Scl (100 kd) 8-10% of IIM. Scleroderma/myositis overlap syndromes, mild myositis, high incidence of arthritis, Raynaud s, interstitial lung disease, calcinosis, sicca Ku (70, 80 kd) 20% of scleroderma/myosistis overlap syndrome, frequent Raynaud s, arthritis and reflux Anti-Ro-52 kd 12% of adult idiopathic inflammatory myopathies (IIM) overall, but 17% of subjects with myositis overlap syndrome; associated with Jo-1 antibodies U1-RNP 10% of IIM; overlap syndromes, most likely MCTD U2-RNP (31/28 kd) 5% of IIM; Scleroderma/myositis overlap syndrome U3-RNP (Fibrillarin) (34 kd) Myositis overlap syndrome, 6-8% of all SSc; 5% in diffuse form (mainly in African Americans); 10% in CREST; skeletal muscle and small bowel involvement; pulmonary hypertension AM: Adult Myositis CADM: Clinically Amyopathic Dermatomyositis CAM: Clinically Amyopathic Myositis DM: Dermatomyositis IIM: Idiopathic Inflammatory Myopathy JM: Juvenile Myositis JDM: Juvenile Dermatomyositis MCTD: Mixed Connective Tissue Disease PM: Polymyositis SSc: Systemic Sclerosis Myositis and related disorders can be challenging to diagnose and differentiate from related disorders. Our Medical Directors are available to discuss any results.

6 Proximal muscle atrophy and weakness in Polymyositis Potential skin manifestations of Dermatomyositis Scalp rash Heliotrope rash Facial rash Shawl rash Muscle atrophy Muscle atrophy Grotton s sign Muscle atrophy Polymyositis, the prototype of chronic idiopathic inflammatory myopathy, causes pain, weakness and proximal muscle atrophy. Dermatomyositis is characterized by identical symptoms and signs with the addition of serious vasculitic skin rashes. This figure illustrates the areas of possible muscle atrophy for both diseases and the typical skin rashes associated with Dermatomyositis. Please visit our website, for additional information.