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. 2004 Mar;63(3):297–301. doi: 10.1136/ard.2003.006122

Interstitial lung disease, a common manifestation of newly diagnosed polymyositis and dermatomyositis

M Fathi 1, M Dastmalchi 1, E Rasmussen 1, I Lundberg 1, G Tornling 1
PMCID: PMC1754925  PMID: 14962966

Abstract

Objectives: To estimate the prevalence and predictors of interstitial lung disease in newly diagnosed polymyositis and dermatomyositis.

Methods: A prospective study in which consecutive patients with newly diagnosed poly- and dermatomyositis, regardless of clinical symptoms of pulmonary disease, were investigated with chest x ray, high resolution computed tomography (HRCT), pulmonary function tests, and biochemical and autoantibody analysis. Patients with inclusion body myositis, malignancy, other defined inflammatory connective tissue diseases (CTDs), or antibody profile indicating other CTDs were excluded.

Results: Between March 1998 and September 2000, 26 new cases of poly- or dermatomyositis were diagnosed; 17 of those patients were included in the study. Interstitial lung disease (ILD), defined as radiological signs on chest x ray examination/HRCT or restrictive ventilatory defect, were found in 11 (65%) patients and were more common in men than in women. Arthritis and occurrence of anti-Jo-1 antibodies were found more often in patients with ILD than in those without. There was no statistically significant association between respiratory symptoms, other serological or laboratory variables and ILD.

Conclusions: ILD is a common early manifestation in patients with poly- and dermatomyositis and is not always related to clinical symptoms. Chest x ray examination, HRCT, pulmonary function tests, and analysis of anti-Jo-1 antibodies should be included in the initial investigation of patients with myositis regardless of respiratory symptoms.

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Selected References

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  1. BLAKEMORE W. S., FORSTER R. E., MORTON J. W., OGILVIE C. M. A standardized breath holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest. 1957 Jan;36(1 Pt 1):1–17. doi: 10.1172/JCI103402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Benbassat J., Gefel D., Larholt K., Sukenik S., Morgenstern V., Zlotnick A. Prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninety-two cases. Arthritis Rheum. 1985 Mar;28(3):249–255. doi: 10.1002/art.1780280303. [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. Bohan A., Peter J. B. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975 Feb 20;292(8):403–407. doi: 10.1056/NEJM197502202920807. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. Engström C. P., Persson L. O., Larsson S., Sullivan M. Health-related quality of life in COPD: why both disease-specific and generic measures should be used. Eur Respir J. 2001 Jul;18(1):69–76. doi: 10.1183/09031936.01.00044901. [DOI] [PubMed] [Google Scholar]
  7. Frank M. B., McCubbin V., Trieu E., Wu Y., Isenberg D. A., Targoff I. N. The association of anti-Ro52 autoantibodies with myositis and scleroderma autoantibodies. J Autoimmun. 1999 Mar;12(2):137–142. doi: 10.1006/jaut.1998.0265. [DOI] [PubMed] [Google Scholar]
  8. Frazier A. R., Miller R. D. Interstitial pneumonitis in association with polymyositis and dermatomyositis. Chest. 1974 Apr;65(4):403–407. doi: 10.1378/chest.65.4.403. [DOI] [PubMed] [Google Scholar]
  9. Gabbay E., Tarala R., Will R., Carroll G., Adler B., Cameron D., Lake F. R. Interstitial lung disease in recent onset rheumatoid arthritis. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):528–535. doi: 10.1164/ajrccm.156.2.9609016. [DOI] [PubMed] [Google Scholar]
  10. Griggs R. C., Askanas V., DiMauro S., Engel A., Karpati G., Mendell J. R., Rowland L. P. Inclusion body myositis and myopathies. Ann Neurol. 1995 Nov;38(5):705–713. doi: 10.1002/ana.410380504. [DOI] [PubMed] [Google Scholar]
  11. Hochberg M. C., Feldman D., Stevens M. B., Arnett F. C., Reichlin M. Antibody to Jo-1 in polymyositis/dermatomyositis: association with interstitial pulmonary disease. J Rheumatol. 1984 Oct;11(5):663–665. [PubMed] [Google Scholar]
  12. Koh E. T., Seow A., Ong B., Ratnagopal P., Tjia H., Chng H. H. Adult onset polymyositis/dermatomyositis: clinical and laboratory features and treatment response in 75 patients. Ann Rheum Dis. 1993 Dec;52(12):857–861. doi: 10.1136/ard.52.12.857. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Love L. A., Leff R. L., Fraser D. D., Targoff I. N., Dalakas M., Plotz P. H., Miller F. W. A new approach to the classification of idiopathic inflammatory myopathy: myositis-specific autoantibodies define useful homogeneous patient groups. Medicine (Baltimore) 1991 Nov;70(6):360–374. doi: 10.1097/00005792-199111000-00002. [DOI] [PubMed] [Google Scholar]
  14. Marie I., Hatron P. Y., Hachulla E., Wallaert B., Michon-Pasturel U., Devulder B. Pulmonary involvement in polymyositis and in dermatomyositis. J Rheumatol. 1998 Jul;25(7):1336–1343. [PubMed] [Google Scholar]
  15. Medsger T. A., Jr, Robinson H., Masi A. T. Factors affecting survivorship in polymyositis. A life-table study of 124 patients. Arthritis Rheum. 1971 Mar-Apr;14(2):249–258. doi: 10.1002/art.1780140210. [DOI] [PubMed] [Google Scholar]
  16. Miller F. W. Myositis-specific autoantibodies. Touchstones for understanding the inflammatory myopathies. JAMA. 1993 Oct 20;270(15):1846–1849. doi: 10.1001/jama.270.15.1846. [DOI] [PubMed] [Google Scholar]
  17. Oddis C. V., Conte C. G., Steen V. D., Medsger T. A., Jr Incidence of polymyositis-dermatomyositis: a 20-year study of hospital diagnosed cases in Allegheny County, PA 1963-1982. J Rheumatol. 1990 Oct;17(10):1329–1334. [PubMed] [Google Scholar]
  18. Plotz P. H., Dalakas M., Leff R. L., Love L. A., Miller F. W., Cronin M. E. Current concepts in the idiopathic inflammatory myopathies: polymyositis, dermatomyositis, and related disorders. Ann Intern Med. 1989 Jul 15;111(2):143–157. doi: 10.7326/0003-4819-111-2-143. [DOI] [PubMed] [Google Scholar]
  19. Primack S. L., Müller N. L. Radiologic manifestations of the systemic autoimmune diseases. Clin Chest Med. 1998 Dec;19(4):573-86, vii. doi: 10.1016/s0272-5231(05)70104-0. [DOI] [PubMed] [Google Scholar]
  20. Rutjes S. A., Vree Egberts W. T., Jongen P., Van Den Hoogen F., Pruijn G. J., Van Venrooij W. J. Anti-Ro52 antibodies frequently co-occur with anti-Jo-1 antibodies in sera from patients with idiopathic inflammatory myopathy. Clin Exp Immunol. 1997 Jul;109(1):32–40. doi: 10.1046/j.1365-2249.1997.4081308.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. 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]
  22. Schumacher H. R., Schimmer B., Gordon G. V., Bookspan M. A., Brogadir S., Dorwart B. B. Articular manifestations of polymyositis and dermatomyositis. Am J Med. 1979 Aug;67(2):287–292. doi: 10.1016/0002-9343(79)90404-2. [DOI] [PubMed] [Google Scholar]
  23. Schwarz M. I. The lung in polymyositis. Clin Chest Med. 1998 Dec;19(4):701-12, viii. doi: 10.1016/s0272-5231(05)70111-8. [DOI] [PubMed] [Google Scholar]
  24. Tazelaar H. D., Viggiano R. W., Pickersgill J., Colby T. V. Interstitial lung disease in polymyositis and dermatomyositis. Clinical features and prognosis as correlated with histologic findings. Am Rev Respir Dis. 1990 Mar;141(3):727–733. doi: 10.1164/ajrccm/141.3.727. [DOI] [PubMed] [Google Scholar]
  25. Venables P. J. Antibodies to Jo-1 and Ro-52: why do they go together? Clin Exp Immunol. 1997 Sep;109(3):403–405. doi: 10.1046/j.1365-2249.1997.4761369.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Weitoft T. Occurrence of polymyositis in the county of Gävleborg, Sweden. Scand J Rheumatol. 1997;26(2):104–106. doi: 10.3109/03009749709115827. [DOI] [PubMed] [Google Scholar]
  27. Yoshida S., Akizuki M., Mimori T., Yamagata H., Inada S., Homma M. The precipitating antibody to an acidic nuclear protein antigen, the Jo-1, in connective tissue diseases. A marker for a subset of polymyositis with interstitial pulmonary fibrosis. Arthritis Rheum. 1983 May;26(5):604–611. doi: 10.1002/art.1780260505. [DOI] [PubMed] [Google Scholar]

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