Interstitial lung disease in polymyositis and dermatomyositis.
The aim of the study was to estimate the prevalence, characteristics, and prognostic factors of interstitial lung disease (ILD) in patients with polymyositis (PM) and dermatomyositis (DM). The medical records of 151 PM/DM patients treated at Chang Gung Memorial Hospital between January, 2000 and June, 2007 were retrospectively reviewed. Thirty of 151 (19.9%) PM/DM patients had developed ILD. Older age at PM/DM onset, anti-Jo-1 antibody, and arthritis/arthralgia were associated with the presence of ILD (p = 0.004, p = 0.008, and p = 0.026, respectively). Anti-Jo-1 was initially excluded from the multivariate analysis because only 80 patients underwent the test. An older age at onset above 45 years (odds ratio 3.28, 95% confidence interval (CI) 1.15-9.34, p = 0.026) and arthritis/arthralgia at onset (odds ratio (OR) 2.57, 95% CI 1.09-6.08, p = 0.032) were the two independent risk factors for developing ILD. If anti-Jo-1 was included in the multivariate analysis (n = 80), then an older age at onset above 45 years (OR 7.30, 95% CI 1.70-31.40, p = 0.008) and anti-Jo-1 positive (OR 7.89, 95% CI 1.18-52.87, p = 0.033) were associated with ILD, while arthritis/arthralgia was no longer significant (OR 2.64, 95% CI 0.70-10.01, p = 0.153). Of the 30 ILD patients, 16 (53.3%) died. The survival time was significantly shorter in ILD patients than in patients without ILD (p < 0.001). Poor survival in ILD patients was associated with male gender (p = 0.039), a Hamman-Rich-like presentation (p = 0.039), and a clinical diagnosis of acute interstitial pneumonia (p = 0.007).
Chen
I-Jung
IJ
Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taiwan, Republic of China.
Jan Wu
Yeong-Jian
YJ
Lin
Cho-Wei
CW
Fan
Kang-Wei
KW
Luo
Shue-Fen
SF
Ho
Huei-Huang
HH
Liou
Lieh-Bang
LB
Tsai
Wen-Pin
WP
Chen
Ji-Yih
JY
Yang
Chung-Han
CH
Kuo
Chang-Fu
CF
Yu
Kuang-Hui
KH
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D003882:Dermatomyositis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017285:Polymyositis / Q000150:complications*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies
D000974:Antibodies, Antinuclear; C046750:Jo-1 antibody