論文

国際誌
2010年9月

Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis.

Rheumatology (Oxford, England)
  • Takahisa Gono
  • ,
  • Yasushi Kawaguchi
  • ,
  • Takashi Satoh
  • ,
  • Masataka Kuwana
  • ,
  • Yasuhiro Katsumata
  • ,
  • Kae Takagi
  • ,
  • Ikuko Masuda
  • ,
  • Akiko Tochimoto
  • ,
  • Sayumi Baba
  • ,
  • Yuko Okamoto
  • ,
  • Yuko Ota
  • ,
  • Hisashi Yamanaka

49
9
開始ページ
1713
終了ページ
9
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/rheumatology/keq149

OBJECTIVE: The aim of this study is to evaluate the clinical manifestation and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-associated interstitial lung disease (ILD) with DM. METHODS: Fourteen patients who presented with anti-MDA5 antibody and 10 patients with anti-aminoacyl-tRNA synthetase (ARS) antibody were enrolled. All patients were diagnosed as having DM with ILD. Clinical manifestations in the patients with anti-MDA5 antibody were compared with those in the patients with anti-ARS antibody. RESULTS: The frequencies of acute/subacute interstitial pneumonia (A/SIP) and fatal outcome were significantly higher in the subset with anti-MDA5 antibody. The creatine kinase (CK) value was significantly lower and the gamma-glutamyl transpeptidase and ferritin values were significantly higher in the subset with anti-MDA5 antibody. Significant correlations were found between PaO(2)/F(i)O(2) and ferritin (r(s) = -0.59, P = 0.035), alveolar-arterial oxygen difference (A-aDO(2)) and KL-6 (r(s) = 0.73, P = 0.016) and A-aDO(2) and ferritin (r(s) = 0.66, P = 0.013) in the subset with anti-MDA5 antibody. The most significant prognostic factor was ferritin. The cumulative survival rate was significantly lower (P < 0.0001) in the subset with ferritin >or=1600 ng/ml than that in the subset with ferritin <1600 ng/ml in anti-MDA5 antibody-associated ILD. CONCLUSION: Both serum ferritin and anti-MDA5 antibody are powerful indicators for the early diagnosis of A/SIP with DM. Ferritin also predicts disease severity and prognosis for patients with anti-MDA5 antibody. Intensive treatment should be administered to cases that have anti-MDA5 antibody-associated ILD with DM showing hyperferritinaemia, especially if the ferritin level is >or=1600 ng/ml.

リンク情報
DOI
https://doi.org/10.1093/rheumatology/keq149
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/20498012
ID情報
  • DOI : 10.1093/rheumatology/keq149
  • PubMed ID : 20498012

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