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Predictive Features and Clinical Presentation of Interstitial Lung Disease in Inflammatory Myositis

Authors
  • Vojinovic, Tamara1
  • Cavazzana, Ilaria1
  • Ceruti, Paolo2
  • Fredi, Micaela1, 3
  • Modina, Denise2
  • Berlendis, Marialma2
  • Franceschini, Franco1, 3
  • 1 ASST Spedali Civili,
  • 2 Pulmonology Unit, ASST Spedali Civili,
  • 3 University of Brescia,
Type
Published Article
Journal
Clinical Reviews in Allergy & Immunology
Publisher
Springer-Verlag
Publication Date
Nov 03, 2020
Volume
60
Issue
1
Pages
87–94
Identifiers
DOI: 10.1007/s12016-020-08814-5
PMID: 33141387
PMCID: PMC7819919
Source
PubMed Central
Keywords
License
Unknown

Abstract

Interstitial lung disease (ILD) represents one of the most severe extra-muscular features of idiopathic inflammatory myositis (IIM). We aimed to identify any clinical and serological predictors of ILD in a monocentric cohort of 165 IIM patients. ILD+ patients were defined as having restrictive impairment in lung function tests and signs of ILD at chest high-resolution computed tomography (HRCT). Available HRCT images were centralized and classified in different ILD patterns: non-specific interstitial pneumonia (NSIP), organizing pneumonia (OP), usual interstitial pneumonia-like (UIP), indeterminate for UIP, and interstitial lung abnormalities (ILA). Lung function test data were recorded at onset, at 1 and 5 years after ILD diagnosis. ILD was found in 52 IIM patients (31.5%): 46.2% was affected by anti-synthetase syndrome (ARS), 21% by polymyositis (PM), 19% by dermatomyositis (DM), and 13.5% by overlap myositis. Most of ILD+ showed NSIP (31.9%), OP (19%), indeterminate for UIP (19%), and UIP (12.8%) patterns. At multivariate analysis, ILD was predicted by anti-Ro52 ( p : 0.0026) and dyspnea ( p : 0.015) at IIM onset. Most of ILD onset within is 12 months after IIM. In five cases, ILD occurs after 12 months since IIM diagnosis: these patients more frequently show dry cough and anti-Ku antibodies. Anti-Ro52 + ILD patients showed a significant increase of DLCO at 1 and 5 years of follow-up, compared with anti-Ro52 negative cases. ILD occurs in about one third of IIM and was predicted by dyspnea at onset and anti-Ro52 antibodies. Anti-Ro52 defines a subgroup of ILD showing a significant improvement of DLCO during follow-up. This retrospective study has been approved by local ethic committee (ASST-Spedali Civili of Brescia, Italy); protocol number: NP3511 Electronic supplementary material The online version of this article (10.1007/s12016-020-08814-5) contains supplementary material, which is available to authorized users.

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