title: Serum interleukin 6 levels as a useful prognostic predictor of clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease.
abstract: OBJECTIVE
  Rapidly progressive interstitial lung disease (RP-ILD) is life-threatening in patients with clinically amyopathic dermatomyositis (CADM). Useful prognostic markers are necessary for treatment selection. This study aimed to investigate differences in clinical and laboratory characteristics between surviving and non-surviving patients.
  
  
  METHODS
  Twelve CADM patients with RP-ILD were enrolled. Six patients lived (Group A) and six patients died (Group B) after immunosuppressive treatment for RP-ILD. Clinical manifestations and laboratory data before treatment were compared between the two groups.
  
  
  RESULTS
  Among the clinical manifestations and laboratory data examined, serum interleukin 6 (IL-6) levels in Group B were significantly higher than those in Group A (mean ± SD 28.5 ± 21.0 vs. 7.2 ± 1.6 pg/mL; p = 0.009). Simple regression analysis showed that serum IL-6 was the only significant prognostic factor (p = 0.032). Kaplan-Meier estimates showed that the cumulative survival rate was significantly lower in patients with serum IL-6 levels of ≥ 9 pg/mL than in patients with those of < 9 pg/mL (p = 0.04).
  
  
  CONCLUSIONS
  Serum IL-6 levels may predict the prognosis of CADM patients with RP-ILD. The intensity of immunosuppressive treatment can be decided according to serum IL-6 levels at an early phase of the disease.
authors.affiliation: Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine , Akita , Japan.
authors.forename: Mizuho
authors.initials: M
authors.lastname: Nara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsuda
authors.forename: Ayumi
authors.initials: A
authors.lastname: Omokawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Togashi
authors.forename: Shin
authors.initials: S
authors.lastname: Okuyama
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Sawada
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakui
mesh_terms: D000328:Adult; D003882:Dermatomyositis / Q000097:blood / Q000150:complications / Q000401:mortality*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D015850:Interleukin-6
keywords: Anti-melanoma differentiation-associated gene 5 (MAD5) antibody; Dermatomyositis; Interleukin 6; Interstitial lung disease; Prognostic factor