Skip to main content
SpringerLink
Log in

Interstitial lung disease in polymyositis and dermatomyositis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The aim of the study was to estimate the prevalence, characteristics, and prognostic factors of interstitial lung disease (ILD) in patients with polymyositis (PM) and dermatomyositis (DM). The medical records of 151 PM/DM patients treated at Chang Gung Memorial Hospital between January, 2000 and June, 2007 were retrospectively reviewed. Thirty of 151 (19.9%) PM/DM patients had developed ILD. Older age at PM/DM onset, anti-Jo-1 antibody, and arthritis/arthralgia were associated with the presence of ILD (p = 0.004, p = 0.008, and p = 0.026, respectively). Anti-Jo-1 was initially excluded from the multivariate analysis because only 80 patients underwent the test. An older age at onset above 45 years (odds ratio 3.28, 95% confidence interval (CI) 1.15–9.34, p = 0.026) and arthritis/arthralgia at onset (odds ratio (OR) 2.57, 95% CI 1.09–6.08, p = 0.032) were the two independent risk factors for developing ILD. If anti-Jo-1 was included in the multivariate analysis (n = 80), then an older age at onset above 45 years (OR 7.30, 95% CI 1.70–31.40, p = 0.008) and anti-Jo-1 positive (OR 7.89, 95% CI 1.18–52.87, p = 0.033) were associated with ILD, while arthritis/arthralgia was no longer significant (OR 2.64, 95% CI 0.70–10.01, p = 0.153). Of the 30 ILD patients, 16 (53.3%) died. The survival time was significantly shorter in ILD patients than in patients without ILD (p < 0.001). Poor survival in ILD patients was associated with male gender (p = 0.039), a Hamman–Rich-like presentation (p = 0.039), and a clinical diagnosis of acute interstitial pneumonia (p = 0.007).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hepper NG, Ferguson RH, Howard FM Jr (1964) Three types of pulmonary involvement in polymyositis. Med Clin North Am 48:1031–1042

    PubMed  CAS  Google Scholar 

  2. Frazier AR, Miller RD (1974) Interstitial pneumonitis in association with polymyositis and dermatomyositis. Chest 65:403–407

    Article  PubMed  CAS  Google Scholar 

  3. Fathi M, Lundberg IE (2005) Interstitial lung disease in polymyositis and dermatomyositis. Curr Opin Rheumatol 17:701–706

    Article  PubMed  Google Scholar 

  4. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347

    PubMed  CAS  Google Scholar 

  5. Euwer RL, Sontheimer RD (1993) Amyopathic dermatomyositis: a review. J Invest Dermatol 100:124S–127S

    Article  PubMed  CAS  Google Scholar 

  6. Chen YJ, Wu CY, Shen JL (2001) Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study. Br J Dermatol 144:825–831

    Article  PubMed  CAS  Google Scholar 

  7. Ansell BM (1991) Juvenile dermatomyositis. Rheum Dis Clin North Am 17:931–942

    PubMed  CAS  Google Scholar 

  8. Hirakata M, Nagai S (2000) Interstitial lung disease in polymyositis and dermatomyositis. Curr Opin Rheumatol 12:501–508

    Article  PubMed  CAS  Google Scholar 

  9. Tazelaar HD, Viggiano RW, Pickersgill J et al (1990) Interstitial lung disease in polymyositis and dermatomyositis: clinical features and prognosis as correlated with histologic findings. Am Rev Respir Dis 141:727–733

    PubMed  CAS  Google Scholar 

  10. Marie I, Hachulla E, Chérin P et al (2002) Interstitial lung disease in polymyositis and dermatomyositis. Arthritis Rheum 47:614–622

    Article  PubMed  CAS  Google Scholar 

  11. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias (2002) Am J Respir Crit Care Med 165:277–304

    Google Scholar 

  12. Yu KH, Yang CH, Wu YK et al (2006) Diffuse alveolar damage as the initial presentation of dermatomyositis and successfully treated with intravenous immunoglobulin and steroids: a case report. J Musculoskel Pain 14:45–50

    Article  Google Scholar 

  13. MIills ES, Mathews WH (1956) Interstitial pneumonitis in dermatomyositis. J Am Med Assoc 160:1467–1470

    Google Scholar 

  14. Fujisawa T, Suda T, Nakamura Y et al (2005) Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. J Rheumatol 32:58–64

    PubMed  Google Scholar 

  15. Ye S, Chen XX, Lu XY et al (2007) Adult clinically amyopathic dermatomypsitis with rapid progressive interstitial lung disease: a retrospective cohort study. Clin Rheumatol 26:1647–1654

    Article  PubMed  Google Scholar 

  16. Schnabel A, Reuter M, Biederer J et al (2003) Interstitial lung disease in polymyositis and dermatomyositis: clinical course and response to treatment. Semin Arthitis Rheum 32:273–284

    Article  Google Scholar 

  17. Fathi M, Dastmalchi M, Rasmussen E et al (2004) Interstitial lung disease, a common manifestation of newly diagnosed polymyositis and dermatomyositis. Ann Rheum Dis 63:297–301

    Article  PubMed  CAS  Google Scholar 

  18. Grau JM, Miró O, Pedrol E et al (1996) Interstitial lung disease related to dermatomyositis: comparable study with patients without lung involvement. J Rheumatol 23:1921–1926

    PubMed  CAS  Google Scholar 

  19. Kang EH, Lee EB, Shin KC et al (2005) Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology 44:1282–1286

    Article  PubMed  CAS  Google Scholar 

  20. Dankó K, Ponyi A, Constantin T, Borgulya G, Szegedi G (2004) Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine 83:35–42

    Article  PubMed  Google Scholar 

  21. Selva-O'Callaghan A, Labrador-Horrillo M, Muñoz-Gall X et al (2005) Polymyositis/dermatomyositis-associated lung disease: analysis of a series of 81 patients. Lupus 14:534–542

    Article  PubMed  Google Scholar 

  22. Chen YJ, Wu CY, Shen JL (2007) Predicting factors of interstitial lung disease in dermatomyositis and polymyositis. Acta Derm Venereol 87:33–38

    Article  PubMed  CAS  Google Scholar 

  23. Stone KB, Oddis CV, Fertig N et al (2007) Anti-Jo-1 antibody levels correlated with disease activity in idiopathic inflammatory myopathy. Arthritis Rheum 56:3125–3131

    Article  PubMed  CAS  Google Scholar 

  24. Mielnik P, Wiesik-Szewczyk E, Olesinska M et al (2006) Clinical features and prognosis of patients with idiopathic inflammatory myopathies and anti-Jo-1 antibodies. Autoimmunity 39:243–247

    Article  PubMed  CAS  Google Scholar 

  25. Suda T, Fujisawa T, Enomoto N et al (2006) Interstitial lung disease associated with amyopathic dermatomyositis. Eur Respir J 28:1005–1012

    Article  PubMed  CAS  Google Scholar 

  26. Douglas WW, Tazelaar HD, Hartman TE et al (2001) Polymyositis-dermatomyositis- associated interstitial lung disease. Am J Respir Crit Care Med 164:1182–1185

    PubMed  CAS  Google Scholar 

  27. Tansey D, Wells AU, Colby TV et al (2004) Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology 44:585–596

    Article  PubMed  CAS  Google Scholar 

  28. Cottin V, Thivolet-Béjui F, Reynaud-Gaubert M et al (2003) Interstitial lung disease in amyopathic dermatomyositis, dermatomyositis and polymyositis. Eur Respir J 22:245–250

    Article  PubMed  CAS  Google Scholar 

  29. Won Huh J, Soon Kim D, Keun Lee C et al (2007) Two distinct clinical types of interstitial lung disease associated with polymyositis-dermatomyositis. Respir Med 101:1761–1769

    Article  PubMed  Google Scholar 

  30. Ito M, Kaise S, Suzuki S et al (1999) Clinico-laboratory characteristics of patients with dermatomyositis accompanied by rapidly progressive interstitial lung disease. Clin Rheumatol 18:462–467

    Article  PubMed  CAS  Google Scholar 

  31. Oddis CV (2000) Current approach to the treatment of polymyositis and dermatomyositis. Curr Opin Rheumatol 12:492–497

    Article  PubMed  CAS  Google Scholar 

  32. Nawata Y, Kurasawa K, Takabayashi K et al (1999) Corticosteroid resistant interstitial pneumonitis in polymyositis/dermatomyositis: prediction and treatment with cyclosporine. J Rheumatol 26:1527–1533

    PubMed  CAS  Google Scholar 

  33. Yoshida T, Koga H, Saitoh F et al (1999) Pulse intravenous cyclophosphamide treatment for steroid-resistant interstitial pneumonitis associated with polymyositis. Intern Med 38:733–738

    Article  PubMed  CAS  Google Scholar 

  34. Dalakas MC, Illa I, Dambrosia JM et al (1993) A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis. N Engl J Med 329:1993–2000

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

  1. Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5 Fu-Shin St., Kuei-Shan (333), Tao-Yuan, Taiwan, Republic of China

    I-Jung Chen, Yeong-Jian Jan Wu, Cho-Wei Lin, Kang-Wei Fan, Shue-Fen Luo, Huei-Huang Ho, Lieh-Bang Liou, Wen-Pin Tsai, Ji-Yih Chen, Chung-Han Yang, Chang-Fu Kuo & Kuang-Hui Yu

  2. School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China

    I-Jung Chen, Yeong-Jian Jan Wu, Cho-Wei Lin, Kang-Wei Fan, Shue-Fen Luo, Huei-Huang Ho, Lieh-Bang Liou, Ji-Yih Chen & Kuang-Hui Yu

Authors
  1. I-Jung Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yeong-Jian Jan Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cho-Wei Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kang-Wei Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shue-Fen Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Huei-Huang Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lieh-Bang Liou
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Wen-Pin Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ji-Yih Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Chung-Han Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Chang-Fu Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kuang-Hui Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kuang-Hui Yu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, IJ., Jan Wu, YJ., Lin, CW. et al. Interstitial lung disease in polymyositis and dermatomyositis. Clin Rheumatol 28, 639–646 (2009). https://doi.org/10.1007/s10067-009-1110-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-009-1110-6

Keywords

Search

Navigation