Anti-p155/140 Antibody-positive Dermatomyositis with Metastasis Origina­ting from an Unknown Site

Abstract

Dermatomyositis (DM) is a systemic inflammatory myopathy with characteristic cutaneous manifestations (a heliotrope rash, Gottron's papules, paronychial erythema and nailfold bleeding) and is often associated with interstitial lung disease and internal malignancy. Thus far, some autoantibodies specific for myositis have been discovered, including antibodies to aminoacyl-tRNA synthetases (ARS), anti-Mi-2 antibodies, anti-CADM 140 antibody, anti-p155/140 antibody and others (1-3). The various autoantibody-positive subgroups of DM vary in their clinical features. Of these myositis-specific autoantibodies, the anti-p155/140 antibody is a 155-kDa reactive nuclear protein relevant to cancer-associated DM (1, 4-8). However, the frequency of malignancies in patients with anti-p155/140 antibody is undefined because no large epidemiological studies have been undertaken. We describe here a patient with anti-p155/140 antibody-positive DM who had a poorly differentiated metastatic adenocarcinoma; however, the primary tumour could not be identified despite comprehensive examination.