Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1987 Jan;46(1):23–29. doi: 10.1136/ard.46.1.23

Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases.

S Lakhanpal, J T Lie, D L Conn, W J Martin 2nd
PMCID: PMC1002053  PMID: 3813671

Abstract

The clinical and autopsy records of 65 patients with either polymyositis (24) or dermatomyositis (41) and pulmonary disease were reviewed. Pulmonary symptoms were recorded in 43 of the cases and included dyspnoea in 31, cough in 23, and chest pain in six. Interstitial lung disease was noted at autopsy in 27 patients; almost half of these had arthritis. Bronchopneumonia was found in 35 patients, 31 of these had received prednisone. Dysphagia was present in a similar proportion of patients with and without pneumonia. Pulmonary vasculitis was seen in five patients; pulmonary symptoms, arthritis, and raised erythrocyte sedimentation rate were present in four of these cases and all five had associated interstitial lung disease. Other pulmonary manifestations included pulmonary oedema, primary pulmonary malignancy, diffuse alveolar damage, fibrinous pleuritis, pulmonary emboli, and diaphragmatic atrophy. The mean survival after disease onset was 29 months but was much less for those with interstitial lung disease and pulmonary vasculitis.

Full text

PDF
27

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Basset F., Ferrans V. J., Soler P., Takemura T., Fukuda Y., Crystal R. G. Intraluminal fibrosis in interstitial lung disorders. Am J Pathol. 1986 Mar;122(3):443–461. [PMC free article] [PubMed] [Google Scholar]
  2. Bohan A., Peter J. B., Bowman R. L., Pearson C. M. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 1977 Jul;56(4):255–286. doi: 10.1097/00005792-197707000-00001. [DOI] [PubMed] [Google Scholar]
  3. Bohan A., Peter J. B. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975 Feb 13;292(7):344–347. doi: 10.1056/NEJM197502132920706. [DOI] [PubMed] [Google Scholar]
  4. Bunch T. W., Tancredi R. G., Lie J. T. Pulmonary hypertension in polymyositis. Chest. 1981 Jan;79(1):105–107. doi: 10.1378/chest.79.1.105. [DOI] [PubMed] [Google Scholar]
  5. Crystal R. G., Bitterman P. B., Rennard S. I., Hance A. J., Keogh B. A. Interstitial lung diseases of unknown cause. Disorders characterized by chronic inflammation of the lower respiratory tract (first of two parts). N Engl J Med. 1984 Jan 19;310(3):154–166. doi: 10.1056/NEJM198401193100304. [DOI] [PubMed] [Google Scholar]
  6. Crystal R. G., Gadek J. E., Ferrans V. J., Fulmer J. D., Line B. R., Hunninghake G. W. Interstitial lung disease: current concepts of pathogenesis, staging and therapy. Am J Med. 1981 Mar;70(3):542–568. doi: 10.1016/0002-9343(81)90577-5. [DOI] [PubMed] [Google Scholar]
  7. Denbow C. E., Lie J. T., Tancredi R. G., Bunch T. W. Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum. 1979 Oct;22(10):1088–1092. doi: 10.1002/art.1780221007. [DOI] [PubMed] [Google Scholar]
  8. Dickey B. F., Myers A. R. Pulmonary disease in polymyositis/dermatomyositis. Semin Arthritis Rheum. 1984 Aug;14(1):60–76. doi: 10.1016/0049-0172(84)90010-6. [DOI] [PubMed] [Google Scholar]
  9. Duncan P. E., Griffin J. P., Garcia A., Kaplan S. B. Fibrosing alveolitis in polymyositis. A review of histologically confirmed cases. Am J Med. 1974 Oct;57(4):621–626. doi: 10.1016/0002-9343(74)90014-x. [DOI] [PubMed] [Google Scholar]
  10. HEPPER N. G., FERGUSON R. H., HOWARD F. M., Jr THREE TYPES OF PULMONARY INVOLVEMENT IN POLYMYOSITIS. Med Clin North Am. 1964 Jul;48:1031–1042. doi: 10.1016/s0025-7125(16)33432-0. [DOI] [PubMed] [Google Scholar]
  11. Hunninghake G. W., Fauci A. S. Pulmonary involvement in the collagen vascular diseases. Am Rev Respir Dis. 1979 Mar;119(3):471–503. doi: 10.1164/arrd.1979.119.3.471. [DOI] [PubMed] [Google Scholar]
  12. Jansen H. M., Schutte A. J., Elema J. D., Giessen M. V., Reig R. P., Leeuwen M. A., Sluiter H. J., The T. H. Local immune complexes and inflammatory response in patients with chronic interstitial pulmonary disorders associated with collagen vascular diseases. Clin Exp Immunol. 1984 May;56(2):311–320. [PMC free article] [PubMed] [Google Scholar]
  13. Lakhanpal S., Bunch T. W., Ilstrup D. M., Melton L. J., 3rd Polymyositis-dermatomyositis and malignant lesions: does an association exist? Mayo Clin Proc. 1986 Aug;61(8):645–653. doi: 10.1016/s0025-6196(12)62030-8. [DOI] [PubMed] [Google Scholar]
  14. MILLS E. S., MATHEWS W. H. Interstitial pneumonitis in dermatomyositis. J Am Med Assoc. 1956 Apr 28;160(17):1467–1470. doi: 10.1001/jama.1956.02960520029008b. [DOI] [PubMed] [Google Scholar]
  15. Reichlin M., Maddison P. J., Targoff I., Bunch T., Arnett F., Sharp G., Treadwell E., Tan E. M. Antibodies to a nuclear/nucleolar antigen in patients with polymyositis overlap syndromes. J Clin Immunol. 1984 Jan;4(1):40–44. doi: 10.1007/BF00915286. [DOI] [PubMed] [Google Scholar]
  16. Salmeron G., Greenberg S. D., Lidsky M. D. Polymyositis and diffuse interstitial lung disease. A review of the pulmonary histopathologic findings. Arch Intern Med. 1981 Jul;141(8):1005–1010. [PubMed] [Google Scholar]
  17. Schwarz M. I., Matthay R. A., Sahn S. A., Stanford R. E., Marmorstein B. L., Scheinhorn D. J. Interstitial lung disease in polymyositis and dermatomyositis: analysis of six cases and review of the literature. Medicine (Baltimore) 1976 Jan;55(1):89–104. doi: 10.1097/00005792-197601000-00005. [DOI] [PubMed] [Google Scholar]
  18. Songcharoen S., Raju S. F., Pennebaker J. B. Interstitial lung disease in polymyositis and dermatomyositis. J Rheumatol. 1980 May-Jun;7(3):353–360. [PubMed] [Google Scholar]
  19. Venables P. J., Mumford P. A., Maini R. N. Antibodies to nuclear antigens in polymyositis: relationship to autoimmune 'overlap syndromes' and carcinoma. Ann Rheum Dis. 1981 Jun;40(3):217–223. doi: 10.1136/ard.40.3.217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Weaver A. L., Brundage B. H., Nelson R. A., Bischoff M. B. Pulmonary involvement in polymyositis: report of a case with response to corticosteroid therapy. Arthritis Rheum. 1968 Dec;11(6):765–773. doi: 10.1002/art.1780110606. [DOI] [PubMed] [Google Scholar]
  21. Webb D. R., Currie G. D. Pulmonary fibrosis masking polymyositis. Remission with corticosteroid therapy. JAMA. 1972 Nov 27;222(9):1146–1149. [PubMed] [Google Scholar]
  22. Young R. H., Mark G. J. Pulmonary vascular changes in scleroderma. Am J Med. 1978 Jun;64(6):998–1004. doi: 10.1016/0002-9343(78)90455-2. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES