Predictive factors and unfavourable prognostic factors of interstitial lung disease in patients with polymyositis or dermatomyositis: a retrospective study

被引:47
作者
Ji Su-yun [1 ]
Zeng Fan-qin [1 ]
Guo Qing [1 ]
Tan Guo-zhen [1 ]
Tang Hong-feng [1 ]
Luo Yi-jin [1 ]
Tang Zeng-qi [1 ]
Han Yan-fang [1 ]
机构
[1] Sun Yat Sen Univ, Dept Dermatol, Affiliated Hosp 2, Guangzhou 510120, Guangdong, Peoples R China
关键词
dermatomyositis; polymyositis; lung diseases; interstitial; IDIOPATHIC INFLAMMATORY MYOPATHY; MYOSITIS-SPECIFIC AUTOANTIBODIES; CLINICALLY AMYOPATHIC DERMATOMYOSITIS; MYCOPHENOLATE-MOFETIL; PNEUMONITIS;
D O I
10.3760/cma.j.issn.0366-6999.2010.05.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Interstitial lung disease (ILD) is a serious lung complication in polymyositis (PM) and dermatomyositis (DM) which affects prognosis and requires a more aggressive approach in therapy. This study investigated the prevalence, characteristics, predictive factors and unfavourable prognostic factors of ILD in newly diagnosed PM, DM and amyopathic DM (ADM). Methods From January 2000 to December 2008, the medical records of 197 consecutive PM and DM patients at the Second Affiliated Hospital of Sun Yat-Sen University were reviewed excluding overlapping, juvenile, and malignancy-associated cases. The patients were assigned to an ILD (69 patients) and a non-ILD group (128 patients). The clinical features, laboratory findings, and prognosis were compared. Results The multivariate analysis indicated that older age at onset (OR 1.033, 95%CI 1.009-1.058, P=0.007), fever (OR 4.109, 95%CI 1.926-8.767, P <0.001) and arthritis/arthralgia (OR 2.274, 95%CI 1.101-4.695, P=0.026) were the independent predictive factors for developing ILD in PM/DM after excluding anti-Jo-1. Regarding anti-Jo-1, fever (OR 4.912, 95%CI 2.121-11.376, P <0.001) was associated with ILD. Poor survival in ILD patients was associated with ILD clinical subset (RR 0.122,95%CI 0.049-0.399, P <0.001), ADM/DM/PM-ILD (RR 0.140, 95%CI 0.031-0.476, P=0.002), cardiac involvement (RR 4.654, 95%CI 1.391-15.577, P=0.013) and serum albumin level (RR 0.910, 95%CI 0.831-0.997, P=0.042). Conclusions Patients who presented with fever tended to have a higher frequency of PM/DM-associated ILD. A Hamman-Rich-like presentation, ADM-ILD, cardiac involvement and hypoalbuminemia were poor prognostic factors in ILD-PM/DM. Chin Med J 2010;123(5):517-522
引用
收藏
页码:517 / 522
页数:6
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