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The predictive prognostic factors for polymyositis/dermatomyositis-associated interstitial lung disease.

Abstract：

BACKGROUND:Interstitial lung disease (ILD) is the principal cause of death in polymyositis/dermatomyositis (PM/DM). Here we investigated prognostic factors for death and serious infection in PM/DM-ILD using the multicenter database. METHODS:We retrospectively reviewed baseline demographic, clinical and laboratory findings, treatment regimens and outcomes in patients with PM/DM-ILD. The distribution of ILD lesions was evaluated in four divided lung zones of high-resolution computed tomography images. RESULTS:Of 116 patients with PM/DM-ILD, 14 died within 6 months from the diagnosis. As independent risk factors for early death, extended ILD lesions in upper lung fields (odds ratio (OR) 8.01, p = 0.016) and hypocapnia (OR 6.85, p = 0.038) were identified. Serious infection was found in 38 patients, including 11 patients who died of respiratory or multiple infections. The independent risk factors were high serum KL-6 (OR 3.68, p = 0.027), high initial dose of prednisolone (PSL) (OR 4.18, p = 0.013), and combination immunosuppressive therapies (OR 5.51, p < 0.001). CONCLUSION:The present study shows the progression of ILD at baseline is the most critical for survival and that infection, especially respiratory infection, is an additive prognostic factor under the potent immunosuppressive treatment.

journal_name

Arthritis Res Ther

journal_title

Arthritis research & therapy

authors

Sugiyama Y,Yoshimi R,Tamura M,Takeno M,Kunishita Y,Kishimoto D,Yoshioka Y,Kobayashi K,Takase-Minegishi K,Watanabe T,Hamada N,Nagai H,Tsuchida N,Soejima Y,Nakano H,Kamiyama R,Uehara T,Kirino Y,Sekiguchi A,Ihata A,O

doi

10.1186/s13075-017-1506-7

subject

Has Abstract

pub_date

2018-01-11 00:00:00

pages

7

issue

1

eissn

1478-6354

issn

1478-6362

pii

10.1186/s13075-017-1506-7

journal_volume

20

pub_type

杂志文章

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