Evaluation of clinical prognostic factors for interstitial pneumonia in anti-MDA5 antibody-positive dermatomyositis patients. Issue 1 (2nd January 2018)

• Record Type: Journal Article
• Authors: Fujiki, Youhei; Kotani, Takuya; Isoda, Kentaro; Ishida, Takaaki; Shoda, Takeshi; Yoshida, Shuzo; Takeuchi, Tohru; Makino, Shigeki
• Is Part Of: Modern rheumatology. Volume 28:Issue 1(2018)
• Page Start: 133
• Page End: 140
• Publication Date: 2018-01-02
• Subjects: Dermatomyositis -- interstitial pneumonia -- prognosis; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2017.1318468
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objectives: We retrospectively investigated clinical prognostic factors for interstitial pneumonia (IP) in anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM) patients. Methods: Subjects comprised 18 patients with anti-MDA5 Ab-positive DM-IP (9 survivors; 9 deaths). Results: Initial serum albumin levels, ferritin levels, and ground-glass opacity (GGO) scores in the right middle lobes were significantly higher in the death group than in the survivor group ( p = .033, .013, and .005, respectively). Initial alveolar-arterial oxygen gradient (P[A-a]O2 ) was also higher in the death group than in the survivor group ( p = .064). Initial serum ferritin, P[A-a]O2, and right middle lobe GGO score were found to significantly relate to death. Survival rates after 24 weeks were significantly lower among patients with an initial ferritin level of ≥450 ng/mL (25%), P[A-a]O2 of ≥30 mmHg (31%), and a right middle lobe GGO score of ≥2 (11%) than each of the others ( p = .006, .020, and .002, respectively). Conclusions: An initial serum ferritin level of ≥450 ng/mL, P[A-a]O2 of ≥30 mmHg, and right middle lobe GGO score of ≥2 (GGO ≥5% of the lobe) were identified as poor prognostic factors for anti-MDA5 Ab-positive DM-IP patients.