Mortality factors in idiopathic inflammatory myopathy: focusing on malignancy and interstitial lung disease.
OBJECTIVE
The objective of this study was to assess the incidence and common types of concomitant malignancies and to define predictive factors of death in Korean patients with idiopathic inflammatory myopathy (IIM).


METHODS
From January 1989 to May 2011, 162 patients were diagnosed with IIM at a university hospital in Korea. The medical records were retrospectively reviewed. The clinical findings of the patients were compared for malignancy, and the prognostic factors predicting death were analyzed.


RESULTS
Malignancies were found in 17 patients (10.5 %), all of whom had a significantly lower frequency of interstitial lung disease (ILD) and an older age at onset. The main causes of death were ILD and malignancy. Older age at diagnosis, presence of malignancy, rapidly progressive ILD and minimal creatinine phosphokinase (CPK) elevation were independent risk factors for death.


CONCLUSIONS
Malignancy was one of the most serious risk factor for death in our patients with IIM. Early discovery of malignancy is important, and an extensive investigation for common malignancies in each region should be done at diagnosis and for a minimum of 2 years thereafter. As minimally elevated CPK levels in ILD patients may be associated with fatal ILD, an early evaluation and a more aggressive treatment of ILD should be considered in these patients.
Department of Rheumatology, Konkuk University School of Medicine, Chungju-si, Chungbuk-do 380-701, South Korea.
Jin-Hyun
JH
Woo
Yun Jung
YJ
Kim
Jin Ju
JJ
Kim
Chan-Bum
CB
Choi
Yoon-Kyoung
YK
Sung
Tae-Hwan
TH
Kim
Jae-Bum
JB
Jun
Sang-Cheol
SC
Bae
Dae-Hyun
DH
Yoo
D000328:Adult; D017668:Age of Onset; D002423:Cause of Death; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications / Q000401:mortality*; D009369:Neoplasms / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors