The Journal of the Korean Rheumatism Association 2007; 14(1): 15-22
Published online March 30, 2007
© Korean College of Rheumatology
김현숙·서수홍·허지안*·곽승기·주지현·윤종현·김완욱·홍연식·조철수·김호연·박성환
가톨릭대학교 의과대학 내과학교실 류마티스내과, 감염내과*
Correspondence to : Sung-Hwan Park
Objective: To investigate the clinical manifestation and prognostic factors of interstitial lung disease (ILD) in Korean patients with idiopathic inflammatory myopathies include with polymyositis (PM) and dermatomyositis (DM). Methods: Clinical and laboratory data of 110 patients with PM/DM in our rheumatology clinic were investigated. Clinical data including history, medication, pulmonary function tests (PFT) findings, radiologic findings, and labaratory findings were obtained from medical records at the first diagnosis of ILD with PM/DM. ILD was diagnosed on the basis of the imaging abnormalities defined above on definite findings of chest X-rays and high resolution computed tomography (HRCT), restrictive changes on PFT with respiratory symptoms. During the course of treatment, we assessed chest radiograph and HRCT findings. Results: Forty-two PM/DM patients (38.2%) developed ILD. Anti-extracellular nuclear antigen (ENA) antibody, anti-Jo-1 antibody and ground glass opacity in HRCT were significantly high in PM-ILD. However honeycoomb appearance (53%:22%) and fibrosis (41%:6%) in HRCT were significantly high in DM-ILD. Interest in aspects of prognosis including initial steroid treatment response in HRCT were favorable in PM-ILD. There were statistically significant association between normal level of CPK and usual interstitial pneumonia (UIP) pattern in HRCT in DM-ILD. Such cases had resistance to steroid therapy. Overall interval between steroid and immunosuppressant therapy was significantly shorter in those with DM-ILD. Conclusion: The clinical manifestations between PM-ILD and DM-ILD in Korean patients were not significant different from those of other populations. DM-ILD is more refractory to steroid treatment, expecting in poor prognosis compared with PM-ILD. So immediate intensive immunosuppressive therapy should be considered in DM-ILD.
Keywords Interstitial lung disease, Inflammatory myositis, Polymyositis, Dermatomyositis
The Journal of the Korean Rheumatism Association 2007; 14(1): 15-22
Published online March 30, 2007
Copyright © Korean College of Rheumatology.
김현숙·서수홍·허지안*·곽승기·주지현·윤종현·김완욱·홍연식·조철수·김호연·박성환
가톨릭대학교 의과대학 내과학교실 류마티스내과, 감염내과*
Hyun-Sook Kim, M.D., Soo-Hong Seo, M.D., Ji-An Hur, M.D.*, Seung-Ki Kwok, M.D., Ji Hyeon Ju, M.D., Chong-Hyeon Yoon, M.D., Wan-Uk Kim, M.D., Yeon-Sik Hong, M.D., Chul-Soo Cho, M.D., Ho-Youn Kim, M.D., Sung-Hwan Park, M.D.
Division of Rheumatology, Division of Infectious Diseases*, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
Correspondence to:Sung-Hwan Park
Objective: To investigate the clinical manifestation and prognostic factors of interstitial lung disease (ILD) in Korean patients with idiopathic inflammatory myopathies include with polymyositis (PM) and dermatomyositis (DM). Methods: Clinical and laboratory data of 110 patients with PM/DM in our rheumatology clinic were investigated. Clinical data including history, medication, pulmonary function tests (PFT) findings, radiologic findings, and labaratory findings were obtained from medical records at the first diagnosis of ILD with PM/DM. ILD was diagnosed on the basis of the imaging abnormalities defined above on definite findings of chest X-rays and high resolution computed tomography (HRCT), restrictive changes on PFT with respiratory symptoms. During the course of treatment, we assessed chest radiograph and HRCT findings. Results: Forty-two PM/DM patients (38.2%) developed ILD. Anti-extracellular nuclear antigen (ENA) antibody, anti-Jo-1 antibody and ground glass opacity in HRCT were significantly high in PM-ILD. However honeycoomb appearance (53%:22%) and fibrosis (41%:6%) in HRCT were significantly high in DM-ILD. Interest in aspects of prognosis including initial steroid treatment response in HRCT were favorable in PM-ILD. There were statistically significant association between normal level of CPK and usual interstitial pneumonia (UIP) pattern in HRCT in DM-ILD. Such cases had resistance to steroid therapy. Overall interval between steroid and immunosuppressant therapy was significantly shorter in those with DM-ILD. Conclusion: The clinical manifestations between PM-ILD and DM-ILD in Korean patients were not significant different from those of other populations. DM-ILD is more refractory to steroid treatment, expecting in poor prognosis compared with PM-ILD. So immediate intensive immunosuppressive therapy should be considered in DM-ILD.
Keywords: Interstitial lung disease, Inflammatory myositis, Polymyositis, Dermatomyositis
Ji Hyoun Kim, M.D., Jeong Seok Lee, M.D., Ph.D., Byoong Yong Choi, M.D., Yun-Hong Cheon, M.D., Su-Jin Yoo, M.D., Ph.D., Ji Hyeon Ju, M.D., Ph.D., Kichul Shin, M.D., Ph.D., Eu Suk Kim, M.D., Ph.D., Han Joo Baek, M.D., Ph.D., Won Park, M.D., Ph.D., Yeong Wook Song, M.D., Ph.D., Woi-Hyun Hong, Ph.D., Yun Jong Lee, M.D., Ph.D.
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