新しい国際分類基準が投げかけるもの

What the New International Classification Criteria for Idiopathic Inflammatory Myopathy Tell Us

筋炎や壊死性筋症を含む炎症性筋疾患の分類は，1975年にBohanとPeterが定めた臨床所見による分類に始まったものの，筋病理所見による分類などもあり混乱していた。その状況を打開するために多分野の研究者が参加して2017年に新国際分類基準が策定された。日本の症例でも高い感度と特異度がある。この分類は，診断基準と分類基準の持つ矛盾点をも解決しようとする画期的なものであるが，その適応には若干の注意を要する。

Abstract

The classification criteria of idiopathic inflammatory myopathy in the past include the criteria defined phenotypically by Peter and Bohan in 1975 and the criteria defined based on pathological findings in affected muscles. New criteria were defined by international researchers, including the author of this article, from multiple fields to be used widely in different fields in 2017. The criteria were approved by rheumatological societies in Europe and the United States, and validated as excellent criteria in a Japanese cohort. It is known that the criteria used for etiological studies and those for diagnosis should be different in their stringency. In the new criteria, the stringency can be set freely by the users to be used for a wide range of purposes.