Oiwa Hiroshi, Kondo Takeshi, Funaki Masamoto, Morito Toshiaki, Yasui Hiroshi, Kamiya Toru
Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Department of Rheumatology, Medical Corporation Jr Hiroshima Hospital, Hiroshima, Japan.
Arch Rheumatol. 2018 Jan 15;33(3):376-380. doi: 10.5606/ArchRheumatol.2018.6577. eCollection 2018 Sep.
Interstitial lung disease in polymyositis and dermatomyositis is a serious complication, associated with poor prognosis. In this article, we describe two cases with histological findings of organizing pneumonia, based on transbronchial lung biopsy. One is a 66-year-old female patient with clinically amyopathic dermatomyositis with anti-melanoma differentiation-associated gene 5 antibody, and another is a 61-year-old female patient with polymyositis with anti-Jo-1 antibody. Both of our cases rapidly deteriorated to death, and autopsy findings showed diffuse alveolar damage. Our experience indicates that transbronchial biopsy findings of organizing pneumonia may be a poor prognostic factor in clinically amyopathic dermatomyositis and polymyositis, in spite of the profile of myositis-specific antibodies.
多发性肌炎和皮肌炎中的间质性肺疾病是一种严重的并发症，与预后不良相关。在本文中，我们描述了两例经支气管肺活检显示机化性肺炎组织学表现的病例。一例是一名66岁患有临床无肌病性皮肌炎且抗黑色素瘤分化相关基因5抗体阳性的女性患者，另一例是一名61岁患有多发性肌炎且抗Jo-1抗体阳性的女性患者。我们的这两个病例均迅速病情恶化死亡，尸检结果显示弥漫性肺泡损伤。我们的经验表明，尽管有肌炎特异性抗体的特征，但经支气管活检显示的机化性肺炎可能是临床无肌病性皮肌炎和多发性肌炎预后不良的因素。
