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Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis.
Chin Med J (Engl). 2020 Mar 20CM

Abstract

BACKGROUND

Clinically amyopathic dermatomyositis (CADM) is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease (ILD). Poor prognosis of the patients was strongly associated with rapid progressive ILD. The aim of this study was to identify risk factors for prediction of different types of ILD in CADM.

METHODS

In this study, data of 108 inpatients with CADM were collected, including 87 with ILD. The baseline clinical data and laboratory parameters, including myositis-specific and associated antibodies and tumor-associated antigens were analyzed to identify risk factors for acute or subacute interstitial pneumonitis (A/SIP) and chronic interstitial pneumonitis (CIP).

RESULTS

In 87 patients with CADM-ILD, 39 (36.1%) were A/SIP, and 48 (44.4%) were CIP. There were 22 (20.4%) patients with asymptomatic ILD who were detected by routine high resolution computed tomography. Cytokeratin-19 fragment (CYFRA21-1) was significantly higher in CADM-ILD than that in CADM patients without ILD; carcinoembryonic antigen and neuron-specific enolase were significantly elevated in A/SIP than that in CIP. Patients with A/SIP had a higher positive rate of anti-melanoma differentiation-associated gene 5 (MDA5), while patients with CIP had a higher positive rate of anti PL-12 and anti-Ro-52. Logistic regression analysis indicated that elevation of CYFRA21-1 was a risk factor for ILD, higher titer of anti-MDA5 indicated increased likelihood for A/SIP, and higher titer of anti-Ro-52 was also clearly associated with CIP.

CONCLUSIONS

This study indicated that the prevalence of ILD was high in CADM. Asymptomatic ILD has been previously underestimated. Anti-MDA5 was a risk factor for the presence of A/SIP, and CYFRA21-1 was a risk factor for ILD.

Authors+Show Affiliations

Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.Department of Rheumatology, Hulunbeier People's Hospital, Hulunbeier, Inner Mongolia 021008, China.Department of Rheumatology, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050200, China.Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing 100044, China. Center of Clinical Immunology, Peking University, Beijing 100044, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32049748

Citation

Gan, Yu-Zhou, et al. "Risk Factors of Interstitial Lung Diseases in Clinically Amyopathic Dermatomyositis." Chinese Medical Journal, 2020, pp. 644-649.
Gan YZ, Zhang LH, Ma L, et al. Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis. Chin Med J. 2020.
Gan, Y. Z., Zhang, L. H., Ma, L., Sun, F., Li, Y. H., An, Y., Li, Z. G., & Ye, H. (2020). Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis. Chinese Medical Journal, (6), 644-649. https://doi.org/10.1097/CM9.0000000000000691
Gan YZ, et al. Risk Factors of Interstitial Lung Diseases in Clinically Amyopathic Dermatomyositis. Chin Med J. 2020 Mar 20;(6)644-649. PubMed PMID: 32049748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis. AU - Gan,Yu-Zhou, AU - Zhang,Li-Hua, AU - Ma,Lin, AU - Sun,Feng, AU - Li,Yu-Hui, AU - An,Yuan, AU - Li,Zhan-Guo, AU - Ye,Hua, PY - 2020/2/13/pubmed PY - 2020/2/13/medline PY - 2020/2/13/entrez SP - 644 EP - 649 JF - Chinese medical journal JO - Chin. Med. J. IS - 6 N2 - BACKGROUND: Clinically amyopathic dermatomyositis (CADM) is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease (ILD). Poor prognosis of the patients was strongly associated with rapid progressive ILD. The aim of this study was to identify risk factors for prediction of different types of ILD in CADM. METHODS: In this study, data of 108 inpatients with CADM were collected, including 87 with ILD. The baseline clinical data and laboratory parameters, including myositis-specific and associated antibodies and tumor-associated antigens were analyzed to identify risk factors for acute or subacute interstitial pneumonitis (A/SIP) and chronic interstitial pneumonitis (CIP). RESULTS: In 87 patients with CADM-ILD, 39 (36.1%) were A/SIP, and 48 (44.4%) were CIP. There were 22 (20.4%) patients with asymptomatic ILD who were detected by routine high resolution computed tomography. Cytokeratin-19 fragment (CYFRA21-1) was significantly higher in CADM-ILD than that in CADM patients without ILD; carcinoembryonic antigen and neuron-specific enolase were significantly elevated in A/SIP than that in CIP. Patients with A/SIP had a higher positive rate of anti-melanoma differentiation-associated gene 5 (MDA5), while patients with CIP had a higher positive rate of anti PL-12 and anti-Ro-52. Logistic regression analysis indicated that elevation of CYFRA21-1 was a risk factor for ILD, higher titer of anti-MDA5 indicated increased likelihood for A/SIP, and higher titer of anti-Ro-52 was also clearly associated with CIP. CONCLUSIONS: This study indicated that the prevalence of ILD was high in CADM. Asymptomatic ILD has been previously underestimated. Anti-MDA5 was a risk factor for the presence of A/SIP, and CYFRA21-1 was a risk factor for ILD. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/32049748/Risk_factors_of_interstitial_lung_diseases_in_clinically_amyopathic_dermatomyositis L2 - https://doi.org/10.1097/CM9.0000000000000691 DB - PRIME DP - Unbound Medicine ER -
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