論文

国際誌
2012年9月

Anti-MDA5 antibody, ferritin and IL-18 are useful for the evaluation of response to treatment in interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis.

Rheumatology (Oxford, England)
  • Takahisa Gono
  • ,
  • Shinji Sato
  • ,
  • Yasushi Kawaguchi
  • ,
  • Masataka Kuwana
  • ,
  • Masanori Hanaoka
  • ,
  • Yasuhiro Katsumata
  • ,
  • Kae Takagi
  • ,
  • Sayumi Baba
  • ,
  • Yuko Okamoto
  • ,
  • Yuko Ota
  • ,
  • Hisashi Yamanaka

51
9
開始ページ
1563
終了ページ
70
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/rheumatology/kes102

OBJECTIVE: The aim of this study was to investigate the precise clinical characteristics and to analyse the association between the anti-MDA5 antibody (anti-MDA5ab) titre and disease status in patients with anti-MDA5ab-positive DM. METHODS: Twenty-seven patients who presented with DM and were positive for the anti-MDA5ab were enrolled. The association between the clinical manifestations and the clinical parameters, including the anti-MDA5ab, was analysed. RESULTS: The complication of rapidly progressive interstitial lung disease (RP-ILD) occurred in 20 (74%) patients. The frequencies of fatal outcome, relapse and malignancy were 33, 4 and 4%, respectively. Remarkably, a fatal outcome occurred within the first 6 months. Compared with six non-RP-ILD patients, elderly age at onset, severely involved pulmonary function and high levels of serum ferritin were present in 20 RP-ILD patients with anti-MDA5ab. Alveolar-arterial oxygen difference (AaDO(2)) ≥32 mmHg and ferritin ≥828 ng/ml at admission were poor prognostic factors in RP-ILD patients with anti-MDA5ab-positive DM. The median value of the anti-MDA5ab titre on admission was higher in patients who later died than in those who survived. The efficacy of treatment was indicated by the anti-MDA5ab, ferritin and IL-18 concentrations. The decline index of the anti-MDA5ab titre after treatment was lower in the subset of patients who died than in the subset of patients who lived. Sustained high levels of anti-MDA5ab, ferritin and IL-18 were present in the patients who died. CONCLUSION: Anti-MDA5ab titre and ferritin and IL-18 concentrations are useful for the evaluation of the response to treatment and the status of ILD in patients with anti-MAD5ab-positive DM.

リンク情報
DOI
https://doi.org/10.1093/rheumatology/kes102
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22589330
ID情報
  • DOI : 10.1093/rheumatology/kes102
  • PubMed ID : 22589330

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