Recurrent juvenile dermatomyositis and cutaneous necrotizing arteritis with molecular mimicry between streptococcal type 5 M protein and human skeletal myosin

• Published in: The Journal of pediatrics Vol. 121; no. 5; pp. 739 - 742
• Main Authors: Martini, Alberto, Ravelli, Angelo, Albani, Salvatore, Viola, Stefania, Scotta, M. Serenella, Magrini, Umberto, Burgio, G. Roberto
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.11.1992
• Subjects: Acute Disease; Adult; Antigens, Bacterial; Antistreptolysin - analysis; Bacterial Outer Membrane Proteins; Bacterial Proteins - chemistry; Carrier Proteins; Dermatomyositis - complications; Dermatomyositis - immunology; Dermatomyositis - metabolism; Dermatomyositis - microbiology; Humans; Male; Myosins - chemistry; Necrosis; Polyarteritis Nodosa - complications; Polyarteritis Nodosa - immunology; Polyarteritis Nodosa - metabolism; Polyarteritis Nodosa - microbiology; Recurrence; Sequence Homology, Amino Acid; Skin Diseases, Vascular - complications; Skin Diseases, Vascular - immunology; Skin Diseases, Vascular - metabolism; Skin Diseases, Vascular - microbiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(05)81905-5

An adult patient had a syndrome associating the features of juvenile dermatomyositis and cutaneous polyarteritis nodosa that followed a cyclic course from childhood; recurrences were always associated with a rise of serum antistreptococcal antibodies. Regions of homology between streptococcal type 5 M protein and skeletal myosin were found. These findings suggest that streptococcal infection, possibly through a molecular mimicry mechanism, played a role in the pathogenesis of the disease in our patient.