Diagnosis

A contemporary NEJM review of idiopathic inflammatory myopathies — the five-subtype framework (IBM, IMNM, antisynthetase syndrome, overlap, dermatomyositis), the autoantibody revolution that now anchors classification, and the shift toward subtype-specific therapy with biologics, JAK/TYK2 inhibitors, and CAR-T.

In a 28,781-patient EMR phenome-wide study, a high ANA titer (≥1:640) without autoimmune disease was strongly enriched for non-AI liver disease (NAFLD/NASH, alcohol-related) and metabolic comorbidity — broadening the differential for an unexplained high-titer ANA beyond the usual autoimmune workup.