Clinical and serological features of patients with dermatomyositis complicated by spontaneous pneumomediastinum

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• 作者：Xiaolei Ma ; Zhiyong Chen ; Wei Hu ; Ziwei Guo ; Yan Wang…
• 关键词：Comorbidity ; Lung disease ; Other aspects of RMDs ; Myositis ; Rheumatic diseases
• 刊名：Clinical Rheumatology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：35
• 期：2
• 页码：489-493
• 全文大小：234 KB
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• 作者单位：Xiaolei Ma (1)
  Zhiyong Chen (2)
  Wei Hu (3)
  Ziwei Guo (2)
  Yan Wang (1)
  Masataka Kuwana (4)
  Lingyun Sun (1)
  
  1. Department of Rheumatology and Immunology, Drum Tower Clinical Medical College of Nanjing Medical University, 140 Hanzhong Road, Nanjing, 210029, China
  2. Department of Rheumatology and Immunology, the Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
  3. Department of Clinical Laboratory, the Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
  4. Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Rheumatology
  
• 出版者：Springer London
• ISSN：1434-9949

文摘

The purpose of this study was to explore the clinical and serological features of patients with pneumomediastinum (PNM) and dermatomyositis-associated interstitial lung disease (DM-ILD). A total of 93 patients (68 with classic DM and 25 with clinically amyopathic DM [CADM]) were recruited. Clinical and laboratory data were collected retrospectively. Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies were detected using enzyme-linked immunosorbent assay (ELISA). Variables were compared between patients with and those without PNM. Multivariate analysis was performed using a multivariate logistic regression model. A total of 11 patients developed spontaneous PNM. During the follow-up period, 6 patients died of respiratory failure. No differences in sex, age at the onset of DM, serum ferritin levels, and C-reactive protein (CRP) levels were observed between DM patients with and without PNM. Compared with DM patients without PNM, those with PNM had significantly higher frequencies of rapidly progressive ILD (RP-ILD) (63.6 vs 24.4 %, P = 0.01), anti-MDA5 antibodies (90.9 vs 52.4 %, P = 0.02), CADM diagnoses (63.6 vs 22.0 %, P = 0.007) and cutaneous ulcers (36.4 vs 11 %, P = 0.04), but significantly lower creatine kinase (CK) levels (58.5 vs 284 U/l, P = 0.04). The multivariate analysis indicated that cutaneous ulcer was the only independent risk factor for the occurrence of PNM in DM (OR = 5.98, 95 % confidence interval [CI] 1.12–31.98, P = 0.037). PNM is a refractory complication and tends to occur in DM patients with RP-ILD, anti-MDA5 antibody, CADM diagnosis, and low CK level, and especially in patients with cutaneous ulcers. Keywords Comorbidity Lung disease Other aspects of RMDs, Myositis Rheumatic diseases