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Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis.
Rheumatology (Oxford) 2010; 49(9):1713-9R

Abstract

OBJECTIVE

The aim of this study is to evaluate the clinical manifestation and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-associated interstitial lung disease (ILD) with DM.

METHODS

Fourteen patients who presented with anti-MDA5 antibody and 10 patients with anti-aminoacyl-tRNA synthetase (ARS) antibody were enrolled. All patients were diagnosed as having DM with ILD. Clinical manifestations in the patients with anti-MDA5 antibody were compared with those in the patients with anti-ARS antibody.

RESULTS

The frequencies of acute/subacute interstitial pneumonia (A/SIP) and fatal outcome were significantly higher in the subset with anti-MDA5 antibody. The creatine kinase (CK) value was significantly lower and the gamma-glutamyl transpeptidase and ferritin values were significantly higher in the subset with anti-MDA5 antibody. Significant correlations were found between PaO(2)/F(i)O(2) and ferritin (r(s) = -0.59, P = 0.035), alveolar-arterial oxygen difference (A-aDO(2)) and KL-6 (r(s) = 0.73, P = 0.016) and A-aDO(2) and ferritin (r(s) = 0.66, P = 0.013) in the subset with anti-MDA5 antibody. The most significant prognostic factor was ferritin. The cumulative survival rate was significantly lower (P < 0.0001) in the subset with ferritin >or=1600 ng/ml than that in the subset with ferritin <1600 ng/ml in anti-MDA5 antibody-associated ILD.

CONCLUSION

Both serum ferritin and anti-MDA5 antibody are powerful indicators for the early diagnosis of A/SIP with DM. Ferritin also predicts disease severity and prognosis for patients with anti-MDA5 antibody. Intensive treatment should be administered to cases that have anti-MDA5 antibody-associated ILD with DM showing hyperferritinaemia, especially if the ferritin level is >or=1600 ng/ml.

Authors+Show Affiliations

Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-Ku, Tokyo 162-0054, 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 available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20498012

Citation

Gono, Takahisa, et al. "Clinical Manifestation and Prognostic Factor in Anti-melanoma Differentiation-associated Gene 5 Antibody-associated Interstitial Lung Disease as a Complication of Dermatomyositis." Rheumatology (Oxford, England), vol. 49, no. 9, 2010, pp. 1713-9.
Gono T, Kawaguchi Y, Satoh T, et al. Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis. Rheumatology (Oxford). 2010;49(9):1713-9.
Gono, T., Kawaguchi, Y., Satoh, T., Kuwana, M., Katsumata, Y., Takagi, K., ... Yamanaka, H. (2010). Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis. Rheumatology (Oxford, England), 49(9), pp. 1713-9. doi:10.1093/rheumatology/keq149.
Gono T, et al. Clinical Manifestation and Prognostic Factor in Anti-melanoma Differentiation-associated Gene 5 Antibody-associated Interstitial Lung Disease as a Complication of Dermatomyositis. Rheumatology (Oxford). 2010;49(9):1713-9. PubMed PMID: 20498012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis. AU - Gono,Takahisa, AU - Kawaguchi,Yasushi, AU - Satoh,Takashi, AU - Kuwana,Masataka, AU - Katsumata,Yasuhiro, AU - Takagi,Kae, AU - Masuda,Ikuko, AU - Tochimoto,Akiko, AU - Baba,Sayumi, AU - Okamoto,Yuko, AU - Ota,Yuko, AU - Yamanaka,Hisashi, Y1 - 2010/05/23/ PY - 2010/5/26/entrez PY - 2010/5/26/pubmed PY - 2011/3/12/medline SP - 1713 EP - 9 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 49 IS - 9 N2 - OBJECTIVE: The aim of this study is to evaluate the clinical manifestation and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-associated interstitial lung disease (ILD) with DM. METHODS: Fourteen patients who presented with anti-MDA5 antibody and 10 patients with anti-aminoacyl-tRNA synthetase (ARS) antibody were enrolled. All patients were diagnosed as having DM with ILD. Clinical manifestations in the patients with anti-MDA5 antibody were compared with those in the patients with anti-ARS antibody. RESULTS: The frequencies of acute/subacute interstitial pneumonia (A/SIP) and fatal outcome were significantly higher in the subset with anti-MDA5 antibody. The creatine kinase (CK) value was significantly lower and the gamma-glutamyl transpeptidase and ferritin values were significantly higher in the subset with anti-MDA5 antibody. Significant correlations were found between PaO(2)/F(i)O(2) and ferritin (r(s) = -0.59, P = 0.035), alveolar-arterial oxygen difference (A-aDO(2)) and KL-6 (r(s) = 0.73, P = 0.016) and A-aDO(2) and ferritin (r(s) = 0.66, P = 0.013) in the subset with anti-MDA5 antibody. The most significant prognostic factor was ferritin. The cumulative survival rate was significantly lower (P < 0.0001) in the subset with ferritin >or=1600 ng/ml than that in the subset with ferritin <1600 ng/ml in anti-MDA5 antibody-associated ILD. CONCLUSION: Both serum ferritin and anti-MDA5 antibody are powerful indicators for the early diagnosis of A/SIP with DM. Ferritin also predicts disease severity and prognosis for patients with anti-MDA5 antibody. Intensive treatment should be administered to cases that have anti-MDA5 antibody-associated ILD with DM showing hyperferritinaemia, especially if the ferritin level is >or=1600 ng/ml. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/20498012/Clinical_manifestation_and_prognostic_factor_in_anti_melanoma_differentiation_associated_gene_5_antibody_associated_interstitial_lung_disease_as_a_complication_of_dermatomyositis_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/keq149 DB - PRIME DP - Unbound Medicine ER -