Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis  

作　　者：Yu-Zhou Gan Li-Hua Zhang Lin Ma Feng Sun Yu-Hui Li Yuan An Zhan-Guo Li Hua Ye 

机构地区：[1]Department of Rheumatology Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis(BZ0135),Peking University People's Hospital,Beijing 100044,China [2]Center of Clinical Immunology,Peking University,Beijing 100044,China [3]Department of Rheumatology,Hulunbeier People's Hospital,Hulunbeier,Inner Mongolia 021008,China [4]Department of Rheumatology,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050200,China

出　　处：《Chinese Medical Journal》2020年第6期644-649,共6页中华医学杂志（英文版）

基　　金：This work was supported by grants from the National Natural Science Foundation of China(Nos.81801615 and 81871289).

摘　　要：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.

关 键 词：Clinically amyopathic DERMATOMYOSITIS INTERSTITIAL lung diseases MYOSITIS AUTOANTIBODIES TUMOR-ASSOCIATED ANTIGEN 

分 类 号：R563[医药卫生—呼吸系统]