Table 2.
Biological, radiological and cytological findings in patients with acute respiratory failure revealing anti-synthetase syndrome or dermato-pulmonary syndrome associated with anti-MDA-5 antibodies
| Missing data | All patients N = 47 |
aMDA-5 ARF N = 19 |
AS ARF N = 28 |
p | |
|---|---|---|---|---|---|
| Biological data at ICU admission, median [IQR] | |||||
| Leukocytes count (103/mm3) | 1 | 11.5 [8.5–17] | 8.4 [6.7–9.8] | 16.0 [12.1–21.1] | < 0.001 |
| C-reactive protein (mg/L) | 9 | 139 [40–208] | 38 [22–99] | 187 [128–262] | 0.30 |
| Procalcitonine (ng/mL) | 9 | 0.30 [0.12–0.56] | 0.32 [0.11–0.48] | 0.30 [0.13–1.42] | < 0.001 |
| Creatininemia (µmol/L) | 14 | 63 [51–78] | 59 [51–73] | 64 [51–80] | 0.04 |
| Creatine kinase (UI/L) | 3 | 157 [69–256] | 127 [75–186] | 192 [69–932] | 0.76 |
| Creatine kinase ≥ 2N | 3 | 9 (20) | 1 (6) | 8 (31) | 0.02 |
| PaCO2 (mmHg) | 1 | 34 [31–41] | 34 [32–42] | 33 [31–41] | 0.06 |
| PaO2/FiO2 (mmHg) | 3 | 123 [83–147] | 139 [91–174] | 117 [78–144] | 0.82 |
| Chest X-ray, n (%) | |||||
| Bilateral opacities | 0 | 45 (96) | 19 (100) | 26 (93) | 0.51 |
| Lower lobe location | 0 | 46 (98) | 19 (100) | 27 (96) | 1.00 |
| Number of quadrants on chest X-ray, n | |||||
| 1 | 0 | 1 (3) | 0 (0) | 1 (4) | 0.30 |
| 2 | 27 (68) | 10 (59) | 17 (74) | ||
| 4 | 12 (30) | 7 (41) | 5 (22) | ||
| Chest CT scan, n (%) | |||||
| Performed | 0 | 47 (100) | 19 (100) | 28 (100) | 1.00 |
| Ground-glass attenuation | 0 | 37 (78) | 18 (96) | 19 (68) | 0.03 |
| Alveolar consolidations | 0 | 35 (75) | 13 (68) | 22 (79) | 0.51 |
| Septal thickening | 0 | 12 (26) | 8 (42) | 4 (14) | 0.05 |
| Pleural effusion | 0 | 13 (28) | 3 (16) | 10 (36) | 0.24 |
| Pneumothorax | 0 | 4 (9) | 3 (16) | 1 (3.6) | 0.29 |
| Pneumomediastinum | 0 | 1 (2) | 1 (5) | 0 (0) | 0.40 |
| Mediastinal lymphadenopathy | 0 | 18 (38) | 7 (37) | 11 (39) | 1.00 |
| Signs of lung fibrosis | 0 | 17 (36) | 6 (32) | 11 (39) | 0.82 |
| Traction bronchiectasis | 0 | 17 (36) | 6 (32) | 11 (39) | 0.82 |
| Reticulations | 0 | 12 (26) | 4 (21) | 8 (29) | 0.78 |
| Honeycombing | 0 | 5 (10) | 1 (5) | 4 (14) | 0.64 |
| Broncho-alveolar lavage (BAL), n (%) or median [IQR] | |||||
| Performed | 0 | 42 (89) | 16 (84) | 26 (93) | 0.38 |
| Delay ICU admission—BAL | 0 | 1 [0–3] | 0 [− 1.5–1.0] | 2 [1–4] | 0.08 |
| Total cell count (103/mL) | 8 | 250 [140–330] | 250 [128–390] | 250 [160–290] | 0.42 |
| Lymphocytes (%) | 1 | 11 [4–30] | 22 [8–34] | 5 [3–17] | 0.06 |
| Neutrophils (%) | 2 | 38 [13–65] | 15 [6–36] | 51 [20–80] | 0.001 |
| Macrophages (%) | 2 | 40 [20–60] | 53 [39–73] | 29 [15–83] | 0.009 |
| Eosinophils (%) | 6 | 0 [0–2] | 0 [0–1] | 0 [0–2] | 0.154 |
| Presence of siderophages | 5 | 2 (4) | 1 (6) | 1 (4) | 1.00 |
| Lung biopsy, n (%) | 0 | 4 (9) | 1 (5) | 3 (11) | – |
| Diffuse alveolar damage | 1 | 0 | 1 | ||
| Usual interstitial pneumonitis | 1 | 0 | 1 | ||
| Organizing pneumonia | 2 | 1 | 1 | ||
| Skin biopsy, n (%) | 0 | 6 (13) | 5 (26) | 1 (4) | – |
| Normal | 1 | 0 | 1 | ||
| Lichenoïd dermatitis | 3 | 3 | 0 | ||
| Dermatomyositis | 2 | 2 | 0 | ||
| Muscle biopsy, n (%) | 0 | 7 (15) | 4 (21) | 3 (11) | – |
| Inflammatory myositis | 7 | 4 | 3 | ||
aMDA-5 anti-MDA-5 antibodies, AS anti-synthetase, ARF acute respiratory failure, BAL broncho-alveolar lavage, ICU intensive care unit, IQR inter-quartile range