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Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis.
J Rheumatol. 2005 Jan; 32(1):58-64.JR

Abstract

OBJECTIVE

To assess the difference in clinical features and prognosis of patients with interstitial lung disease (ILD) comparing polymyositis (PM) and dermatomyositis (DM).

METHODS

Medical records of 28 ILD patients with PM/DM (16 PM-ILD, 12 DM-ILD) were reviewed retrospectively.

RESULTS

Serum CPK concentrations were significantly higher in PM-ILD than in DM-ILD. Bronchoalveolar lavage analysis showed that the percentages of lymphocytes and eosinophils were significantly higher in DM-ILD than in PM-ILD. Ten patients (5 PM-ILD, 5 DM-ILD) underwent surgical lung biopsy, and 3 (3 DM-ILD) had an autopsy. Nonspecific interstitial pneumonia (NSIP) was found in 7 (4 PM-ILD, 3 DM-ILD) and usual interstitial pneumonia (UIP) in 3 (1 PM-ILD, 2 DM-ILD). Interestingly, diffuse alveolar damage (DAD) was found in 3 patients with DM-ILD, who all died of deterioration of ILD; but no one with PM-ILD had DAD. Corticosteroid treatment alone achieved a favorable response in 6 patients (37.5%) with PM-ILD, but in only one (8.3%) with DM-ILD. Administration of cyclosporine in the early phase of onset benefited 4 corticosteroid-resistant patients with DM-ILD. Conclusively, survival in DM-ILD was significantly worse than that in PM-ILD.

CONCLUSION

DM-ILD is more refractory to corticosteroid therapy, resulting in poorer prognosis compared with PM-ILD. These data indicate that intensive therapy, including cyclosporine, should be considered for DM-ILD.

Authors+Show Affiliations

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15630726

Citation

Fujisawa, Tomoyuki, et al. "Differences in Clinical Features and Prognosis of Interstitial Lung Diseases Between Polymyositis and Dermatomyositis." The Journal of Rheumatology, vol. 32, no. 1, 2005, pp. 58-64.
Fujisawa T, Suda T, Nakamura Y, et al. Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. J Rheumatol. 2005;32(1):58-64.
Fujisawa, T., Suda, T., Nakamura, Y., Enomoto, N., Ide, K., Toyoshima, M., Uchiyama, H., Tamura, R., Ida, M., Yagi, T., Yasuda, K., Genma, H., Hayakawa, H., Chida, K., & Nakamura, H. (2005). Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. The Journal of Rheumatology, 32(1), 58-64.
Fujisawa T, et al. Differences in Clinical Features and Prognosis of Interstitial Lung Diseases Between Polymyositis and Dermatomyositis. J Rheumatol. 2005;32(1):58-64. PubMed PMID: 15630726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. AU - Fujisawa,Tomoyuki, AU - Suda,Takafumi, AU - Nakamura,Yutaro, AU - Enomoto,Noriyuki, AU - Ide,Kyotaro, AU - Toyoshima,Mikio, AU - Uchiyama,Hiroshi, AU - Tamura,Ryoji, AU - Ida,Masaaki, AU - Yagi,Takeshi, AU - Yasuda,Kazumasa, AU - Genma,Hitoshi, AU - Hayakawa,Hiroshi, AU - Chida,Kingo, AU - Nakamura,Hirotoshi, PY - 2005/1/5/pubmed PY - 2005/4/15/medline PY - 2005/1/5/entrez SP - 58 EP - 64 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 32 IS - 1 N2 - OBJECTIVE: To assess the difference in clinical features and prognosis of patients with interstitial lung disease (ILD) comparing polymyositis (PM) and dermatomyositis (DM). METHODS: Medical records of 28 ILD patients with PM/DM (16 PM-ILD, 12 DM-ILD) were reviewed retrospectively. RESULTS: Serum CPK concentrations were significantly higher in PM-ILD than in DM-ILD. Bronchoalveolar lavage analysis showed that the percentages of lymphocytes and eosinophils were significantly higher in DM-ILD than in PM-ILD. Ten patients (5 PM-ILD, 5 DM-ILD) underwent surgical lung biopsy, and 3 (3 DM-ILD) had an autopsy. Nonspecific interstitial pneumonia (NSIP) was found in 7 (4 PM-ILD, 3 DM-ILD) and usual interstitial pneumonia (UIP) in 3 (1 PM-ILD, 2 DM-ILD). Interestingly, diffuse alveolar damage (DAD) was found in 3 patients with DM-ILD, who all died of deterioration of ILD; but no one with PM-ILD had DAD. Corticosteroid treatment alone achieved a favorable response in 6 patients (37.5%) with PM-ILD, but in only one (8.3%) with DM-ILD. Administration of cyclosporine in the early phase of onset benefited 4 corticosteroid-resistant patients with DM-ILD. Conclusively, survival in DM-ILD was significantly worse than that in PM-ILD. CONCLUSION: DM-ILD is more refractory to corticosteroid therapy, resulting in poorer prognosis compared with PM-ILD. These data indicate that intensive therapy, including cyclosporine, should be considered for DM-ILD. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/15630726/Differences_in_clinical_features_and_prognosis_of_interstitial_lung_diseases_between_polymyositis_and_dermatomyositis_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=15630726 DB - PRIME DP - Unbound Medicine ER -