title: The prognostic value of HRCT in myositis-associated interstitial lung disease.
abstract: BACKGROUND
  Polymyositis and dermatomyositis-associated interstitial lung disease (PM/DM-ILD) can have variable courses. We evaluated the prognostic value of high-resolution computed tomography (HRCT) in PM/DM-ILD.
  
  
  METHODS
  The cases of 51 patients newly diagnosed with PM/DM-ILD were retrospectively reviewed. HRCT images at diagnosis were categorized into four radiological patterns based on the major findings and distributions of these abnormalities, and the disease extent on HRCT was scored. The impact of HRCT findings and other clinical parameters on day 90 and overall mortality were analyzed.
  
  
  RESULTS
  Of the 51 patients (11 with polymyositis and 40 with dermatomyositis), the lower consolidation/ground-glass attenuation (GGA) pattern was observed in 21 patients (41%), lower reticulation was observed in 23 patients (45%), random GGA was observed in four patients (8%), and other patterns were observed in three patients (6%). Twenty-one patients (42%) were positive for anti-CADM-140. The lower consolidation/GGA pattern, clinically amyopathic dermatomyositis, fever (≥38.0 °C), ferritin levels >500 ng/mL, and the presence of anti-CADM-140 were significantly associated with 90-day mortality in univariate analysis. Multivariate analysis revealed that the lower consolidation/GGA pattern (odds ratio, 23.1; P = 0.02) and the presence of anti-CADM-140 (odds ratio, 14.1; P = 0.03) were independent predictors of 90-day mortality. This HRCT pattern was also associated with a higher 90-day morality rate among anti-CADM-140-positive patients. The lower consolidation/GGA pattern was also associated with overall mortality in univariate analysis, whereas only the presence of anti-CADM-140 was an independent determinant of overall mortality in multivariate analysis.
  
  
  CONCLUSIONS
  HRCT patterns at diagnosis can help predict the prognosis of patients with PM/DM-ILD as well as the presence of anti-CADM-140.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Tanizawa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Handa
authors.forename: Ran
authors.initials: R
authors.lastname: Nakashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hosono
authors.forename: Kensaku
authors.initials: K
authors.lastname: Aihara
authors.forename: Kohei
authors.initials: K
authors.lastname: Ikezoe
authors.forename: Kizuku
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hatta
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Sonoko
authors.initials: S
authors.lastname: Nagai
authors.forename: Tsuneyo
authors.initials: T
authors.lastname: Mimori
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003882:Dermatomyositis / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications* / Q000276:immunology; D010455:Peptides / Q000276:immunology; D017285:Polymyositis / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; C501597:CADM-140 peptide, human; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D036341:Intercellular Signaling Peptides and Proteins; D010455:Peptides