Jensen Mads Lynge, Løkke Anders, Hilberg Ole, Hyldgaard Charlotte, Bendstrup Elisabeth, Tran Dan
Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
Department of Respiratory Diseases, Vejle Hospital, Vejle, Denmark.
Eur Clin Respir J. 2019 Feb 27;6(1):1583516. doi: 10.1080/20018525.2019.1583516. eCollection 2019.
: To describe the clinical characteristics including the bronchoalveolar lavage fluid (BALF) characteristics of patients with antisynthetase syndrome (AS) associated interstitial lung disease (ILD) in a tertiary ILD outpatient clinic, their medical therapy and outcome. : Retrospective cohort study of patients with AS-ILD. All available data of clinical characteristics, pulmonary function tests, laboratory parameters, BALF analysis, histology, high-resolution computed tomography (HRCT) and treatment were collected from the patient files. : Twelve patients with AS-ILD were identified. Mean age at diagnosis was 55 years (range 45-69), 67% were female. Mean follow-up time was 7 years. The anti-aminoacyl tRNA-synthetase antibodies presented were anti-Jo1 ( = 6), anti-PL7 ( = 3), anti-PL12 ( = 2) and anti-EJ ( = 1). HRCT patterns were mainly non-specific interstitial pneumonia (75%). Four patients had BALF-eosinophilia (two of four anti-Jo1 patients) and two anti-PL12 positive patients had BALF-neutrophilia. Two AS-ILD patients improved on rituximab (RTX) as induction treatment and three out of four patients were stabilised on RTX as maintenance treatment. Two patient obtained remission by cyclophosphamide. Four patients were stabilised on azathioprine alone or in combination with oral corticosteroids. Our cohort of AS-ILD patients showed clinical characteristics in accordance with previous reports at baseline and was comparable to other cohorts. Most patients can be stabilised with immunosuppressive treatment.
描述在一家三级间质性肺病门诊中,抗合成酶综合征(AS)相关间质性肺病(ILD)患者的临床特征,包括支气管肺泡灌洗(BAL)液特征、药物治疗及预后。对AS-ILD患者进行回顾性队列研究。从患者病历中收集所有可用的临床特征、肺功能测试、实验室参数、BALF分析、组织学、高分辨率计算机断层扫描(HRCT)及治疗数据。共识别出12例AS-ILD患者。诊断时的平均年龄为55岁(范围45-69岁),67%为女性。平均随访时间为7年。出现的抗氨酰tRNA合成酶抗体为抗Jo1(n=6)、抗PL7(n=3)、抗PL12(n=2)和抗EJ(n=1)。HRCT模式主要为非特异性间质性肺炎(75%)。4例患者BALF嗜酸性粒细胞增多(4例抗Jo1患者中的2例),2例抗PL12阳性患者BALF中性粒细胞增多。2例AS-ILD患者使用利妥昔单抗(RTX)诱导治疗后病情改善,4例患者中有3例使用RTX维持治疗病情稳定。2例患者通过环磷酰胺获得缓解。4例患者单独使用硫唑嘌呤或与口服糖皮质激素联合使用病情稳定。我们的AS-ILD患者队列在基线时显示出与既往报道一致的临床特征,且与其他队列具有可比性。大多数患者可通过免疫抑制治疗实现病情稳定。