Saketkoo Lesley Ann, Ascherman Dana P, Cottin Vincent, Christopher-Stine Lisa, Danoff Sonye K, Oddis Chester V
Louisiana State University Health Sciences Center, Department of Medicine, Division of Rheumatology, New Orleans, LA, USA.
Curr Rheumatol Rev. 2010 May;6(2):108-119. doi: 10.2174/157339710791330740.
The lung is one of the most common extra-muscular targets in idiopathic inflammatory myopathies (IIM) and interstitial lung disease (ILD) is a prevalent and often devastating manifestation of IIM. IIM-associated ILD (IIM-ILD) contributes to nearly 80% of the mortality in IIM with a reported prevalence of 65% of newly diagnosed IIM cases. Although ILD frequently accompanies clinical and laboratory findings of myositis, overt signs of muscle disease may be absent in the setting of significant lung disease. Understanding the varied scope of presentation of these diseases is essential to providing optimal patient care. This review will provide an in depth examination of ILD in IIM both from a rheumatologic and pulmonary perspective and will discuss the scope of disease, presenting features, genetic associations, pathogenesis, diagnosis, radiographic and histopathologic findings, along with biomarker assessment and a rationale for therapeutic intervention.
肺是特发性炎性肌病(IIM)中最常见的肌肉外靶器官之一,间质性肺疾病(ILD)是IIM的一种常见且往往具有毁灭性的表现。IIM相关的ILD(IIM-ILD)导致IIM中近80%的死亡率,新诊断的IIM病例报告患病率为65%。尽管ILD常伴有肌炎的临床和实验室检查结果,但在严重肺部疾病的情况下,可能没有明显的肌肉疾病体征。了解这些疾病的不同表现范围对于提供最佳的患者护理至关重要。本综述将从风湿病学和肺病学的角度对IIM中的ILD进行深入研究,并将讨论疾病范围、呈现特征、遗传关联、发病机制、诊断、影像学和组织病理学发现,以及生物标志物评估和治疗干预的基本原理。