Dysphonia and dysphagia as early manifestations of autoimmune inflammatory myopathy

Samuel F. Weinreb, Krzysztof Piersiala, Alexander T. Hillel, Lee M. Akst, Simon R. Best

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: While dysphagia is a recognized manifestation of autoimmune inflammatory myopathy, a relationship between myositis and dysphonia or laryngeal pathology is not well-documented. We therefore sought to describe the spectrum of laryngeal disorders present in myositis patients, evaluate whether any specific conditions are overrepresented among these patients compared to a large treatment-seeking population, and examine the clinical course and outcomes of these symptoms. Materials and methods: This was a retrospective chart review, including all patients seen at the Johns Hopkins Voice Center between January 2016 and December 2017. Demographic data, comorbidities, and laryngeal diagnoses were extracted from the electronic medical record. The charts of patients with myositis were reviewed further to ascertain details of their laryngeal symptoms and myositis disease course. Associations between myositis and dysphonia/dysphagia were evaluated using binary regression and multinomial logistic regression models to adjust for age, sex, race, and smoking status. Results: Of 4252 patients, sixteen had myositis. Compared to 4236 controls, these patients had significantly higher odds of presenting with muscular voice disorders (adjusted odds ratio (OR*) = 4.503, p* = 0.005) and dysphagia (OR* = 6.823, p* < 0.001). A majority (64.3%, CI:35.6–93.0%) of myositis patients had laryngeal pathology among the presenting symptoms of their myositis. Across all diagnostic categories, there was a non-significant trend towards better outcomes in patients receiving specific interventions for their laryngeal symptoms. Conclusions: Muscular voice disorders and dysphagia are significantly overrepresented in myositis patients presenting to a laryngology clinic, and in these patients, both are frequently among the presenting symptoms of myositis.

Original languageEnglish (US)
Article number102747
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2021

Keywords

  • Deglutition disorders
  • Dermatomyositis
  • Dysphonia
  • Myositis
  • Polymyositis
  • Velopharyngeal insufficiency

ASJC Scopus subject areas

  • Otorhinolaryngology

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