title: Elevated Erythrocyte Sedimentation Rate Is Predictive of Interstitial Lung Disease and Mortality in Dermatomyositis: a Korean Retrospective Cohort Study.
abstract: Interstitial lung disease (ILD) is a major cause of death in patients with dermatomyositis (DM). This study was aimed to examine the utility of the erythrocyte sedimentation rate (ESR) as a predictor of ILD and prognostic marker of mortality in patients with DM. One hundred-and-fourteen patients with DM were examined, including 28 with clinically amyopathic DM (CADM). A diagnosis of ILD was made based on high resolution computed tomography (HRCT) scans. The association between elevated ESR and pulmonary impairment and mortality was then examined. ILD was diagnosed in 53 (46.5%) of 114 DM patients. Cancer was diagnosed in 2 (3.8%) of 53 DM patients with ILD and in 24 (92.3%) of those without ILD (P < 0.001). The median ESR (50.0 mm/hour) in patients with ILD was significantly higher than that in patients without ILD (29.0 mm/hour; P < 0.001). ESR was inversely correlated with forced vital capacity (Spearman ρ = - 0.303; P = 0.007) and carbon monoxide diffusing capacity (ρ = - 0.319; P = 0.006). DM patients with baseline ESR ≥ 30 mm/hour had significantly higher mortality than those with ESR < 30 mm/hour (P = 0.002, log-rank test). Patients with a persistently high ESR despite immunosuppressive therapy was associated with higher mortality than those with a normalized ESR (P = 0.039, log-rank test). Elevated ESR is associated with increased mortality in patients with DM due to respiratory failure. Thus, monitoring ESR should be an integral part of the clinical care of DM patients.
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Dong Jin
authors.identifier: 0000-0001-7350-3491
authors.initials: DJ
authors.lastname: Go
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea .
authors.forename: Eun Young
authors.identifier: 0000-0001-6975-8627
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea .
authors.forename: Eun Bong
authors.identifier: 0000-0003-0703-1208
authors.initials: EB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Yeong Wook
authors.identifier: 0000-0002-5384-3437
authors.initials: YW
authors.lastname: Song
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA .
authors.forename: Maximilian Ferdinand
authors.identifier: 0000-0001-5045-5255
authors.initials: MF
authors.lastname: Konig
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Jin Kyun
authors.identifier: 0000-0003-2167-9393
authors.initials: JK
authors.lastname: Park
mesh_terms: D000328:Adult; D044466:Asian People; D001799:Blood Sedimentation; D002248:Carbon Monoxide / Q000378:metabolism; D015331:Cohort Studies; D003882:Dermatomyositis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D018450:Disease Progression; D004912:Erythrocytes / Q000166:cytology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D056910:Republic of Korea; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D007166:Immunosuppressive Agents; D002248:Carbon Monoxide
keywords: Dermatomyositis; Erythrocyte Sedimentation Rate; Interstitial Lung Disease