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Læknablaðið - 15.08.1992, Page 37

Læknablaðið - 15.08.1992, Page 37
LÆKNABLAÐIÐ 1992; 78: 243-9 245 Table III. Diagnostic criteria for polymyositis and dermatomyositis (19). 1. Proximal muscle weakness 2. Muscle biopsy changes 3. Elevated muscle enzymes in serum 4. Electromyographic abnormalities 5. Characteristic skin rash Diagnosis: Definite: Three or four criteria (plus the rash) for dermatomyositis, and four criteria (without the rash) for polymyositis. Probable: Two criteria (plus the rash) for dermatomyositis, three criteria (without the rash) for polymyositis. Possible: One criteria (plus the rash) for dermatomyositis, two criteria (without the rash) for polymyositis. Table IV. Diagnostic criteria for MCTD (20,21). 1. Serological: Positive anti-RNP in high titer 2. Clinical: Edema of hands Synovitis Myositis Raynaud’s phenomenon Acrosclerosis Requirements for diagnosis: I. Serological And: II. At least three clinical data III. The association of edema of the hands.Raynaud’s phenomenon and acrosclerosis requires at least one of the other two criteria Table V. Mean age at diagnosis in years. Mean age Range SLE........................ 46.6 (SD 18.2) 10-82 SS......................... 49.0 (SD 18.6) 19-81 PM/DM...................... 56.7 (SD 19.5) 24-81 MCTD....................... 25.6 (SD 11.2) 12-41 Table VI. Age standardized annual incidence* of SLE, SS, PM/DM and MCTD in lceland, 1975-1984. Females Males Total 95% C.l. SLE No. of cases..... 67 9 76 Incidence........ 5.8 0.8 3.3 2.6-4.2 SS No. ofcases...... 8 5 13 Incidence........ 0.7 0.4 0.55 0.31-1.0 PM/DM No. of cases.... 5 1 6 Incidence....... 0.3 0.1 0.2 0.1-0.6 MCTD No. of cases.... 5 0 5 Incidence....... 0.4 0.0 0.2 0.07-0.5 * Cases/100,000 inhabitants/year. Svör bárust við yfir 95% fyrirspurna til lækna. Ranðir úlfar: Sjötíu og sex sjúklingar (67 konur og 9 karlar) uppfylltu fjögur eða fleiri skilmerki fyrir rauða úlfa á tímabilinu 1975- 1984. Meðalaldur við greiningu var 46,6 ár með aldursdreifingu 10-82 ár (tafla V). Aldursstaðlað nýgengi var 5,8 fyrir konur og 0,8/100.000/ári fyrir karla, með heildartölu (crude rate) 3,3/100.000/ári (tafla VI). Meðalaldur við fyrstu einkenni var 37,9 ár og meðalgreiningartöf 8,8 ár (tafla VII). Helmingur sjúklinga var þó greindur innan fimm ára frá upphafi einkenna. í árslok 1984 voru 86 sjúklingar á lífi (77 konur og níu karlar). Aldursstaðlað algengi var 62 fyrir konur og 7,2/100.000 fyrir karla með heildartölu 34,6 (tafla VIII). Alls létust 17 sjúklingar á rannsóknartímabilinu og fram til 1. desember 1988. Meðalaldur við dauða var 58,8 ár. Aætluð dánartala sambærilegs viðmiðunarúrtaks var 5, áhættuhlutfallið var því 3,4. Fimm ára lífslíkur voru 84% og 10 ára lífslíkur 78%. Table VII. Mean age at first symptoms and diagnostic delay in years. Mean age Dx.delay SLE.................................................... 37.9 (SD 18.8; range 8-82) 8.8 (range 0-50) SS..................................................... 42.6 (SD 20.0; range 12-71) 5.6 (range 0.7-20) PM/DM.................................................. 56.0 (SD 19.9; range 23-81) 0.5 (range 0.25-1) MCTD................................................... 23.4 (SD 11.7; range 11 -40) 1.75 (range 0.3-6.25)

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