Lung ultrasound B-lines and serum KL-6 correlate with the severity of idiopathic inflammatory myositis-associated interstitial lung disease. (3rd December 2019)

• Record Type: Journal Article
• Authors: Wang, Yukai; Chen, Shaoqi; Lin, Jianqun; Xie, Xuezhen; Hu, Shijian; Lin, Qisheng; Zheng, Kedi; Du, Guangzhou; Huang, Xiufeng; Zhang, Guohong; Gargani, Luna; Matucci-Cerinic, Marco; Furst, Daniel E
• Is Part Of: Rheumatology. Volume 59:Number 8(2020)
• Page Start: 2024
• Page End: 2029
• Publication Date: 2019-12-03
• Subjects: B-lines -- high-resolution CT -- idiopathic inflammatory myositis-associated interstitial lung disease -- KL-6 -- lung ultrasound -- pulmonary function tests; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/kez571
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objective: Idiopathic inflammatory myositis-associated interstitial lung disease (IIM-ILD) significantly increases morbidity and mortality. Lung ultrasound B-lines and Krebs von den Lungen-6 (KL-6) are identified as new sonographic and serum markers of ILD, respectively. The aim of our work was to assess the role of B-lines and KL-6 as markers of the severity of IIM-ILD. For this purpose, the correlation among B-lines score, serum KL-6 levels, high-resolution CT (HRCT) score, and pulmonary function tests were investigated in IIM-ILD patients. Methods: Thirty-eight patients with IIM-ILD underwent chest HRCT scans, lung ultrasound and pulmonary function tests (independently performed within 1 week) examination. To assess severity and extent of ILD at HRCT, the Warrick score was used. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 50 scanning sites. Serum KL-6 levels (U/ml) was measured by chemiluminescent enzyme immunoassay. Results: A significant correlation was found between the B-lines score and serum KL-6 levels ( r = 0.43, P < 0.01), and between the Warrick score and serum KL-6 levels ( r = 0.45, P < 0.01). A positive correlation between B-lines score and the Warrick score ( r = 0.87, P < 0.0001) was also confirmed. Both B-lines score and KL-6 levels inversely correlated to diffusion capacity for carbon monoxide ( r = −0.77, P < 0.0001 and r = −0.42, P < 0.05, respectively) and total lung capacity ( r = −0.73, P < 0.0001 and r = −0.36, P < 0.05, respectively). Moreover, B-lines correlated inversely with forced vital capacity ( r = −0.73, P < 0.0001), forced expiratory volume in 1 s ( r = −0.69, P < 0.0001). Conclusion: B-lines score and serum KL-6 levels correlate with HRCT findings and pulmonary function tests, supporting their use as measures of IIM-ILD severity.