Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Dermatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Rheumatology (Oxford). 2021 Dec 24;61(1):413-421. doi: 10.1093/rheumatology/keab177.
DM-related acute/subacute interstitial lung disease (A/S-ILD) remains a big therapeutic challenge due to its insidious onset and rapid development. In the present study, we aimed to investigate the association between clinical features of DM and ILD.
We retrospectively assessed skin manifestations, muscle damage, laboratory tests, concurrent ILD and malignancy in 207 patients with DM and analysed the high-risk factors for ILD.
In the 207 DM patients, 153 patients had ILD, in which 131 had chronic ILD (CILD) and 22 had A/S-ILD. The proportions of mechanic's hands, palmar papules and muscle weakness, as well as anti-melanoma differentiation-associated gene 5 (MDA5) antibody and lactic dehydrogenase (LDH), alanine aminotransferase (ALT) and ferritin in the ILD group were significantly higher compared with the non-ILD group. The onset age over 56 years, mechanic's hands and muscle weakness were independent predictive factors for ILD. The proportions of palmar papules, palmar erythema, anti-MDA5 antibody, ALT, aspartate aminotransferase (AST), LDH and ESR in the A/S-ILD group were higher compared with the CILD group. Palmar erythema and palmar papules were independent predictive factors for A/S-ILD. Palmar papules were positively correlated with anti-MDA5 antibody.
The onset age over 56 years, mechanic's hands or muscle weakness predicted the incidence of DM-related ILD, while palmar erythema or palmar papules could predict potential DM-related A/S-ILD.
DM 相关的急性/亚急性间质性肺病（A/S-ILD）由于其隐匿的发病和快速发展，仍然是一个巨大的治疗挑战。在本研究中，我们旨在研究 DM 的临床特征与 ILD 之间的关系。
我们回顾性评估了 207 例 DM 患者的皮肤表现、肌肉损伤、实验室检查、并发 ILD 和恶性肿瘤，并分析了 ILD 的高危因素。
在 207 例 DM 患者中，153 例有 ILD，其中 131 例为慢性 ILD（CILD），22 例为 A/S-ILD。ILD 组的机械性手、手掌丘疹和肌肉无力的比例，以及抗黑色素瘤分化相关基因 5（MDA5）抗体和乳酸脱氢酶（LDH）、丙氨酸氨基转移酶（ALT）和铁蛋白明显高于非 ILD 组。发病年龄超过 56 岁、机械性手和肌肉无力是 ILD 的独立预测因素。手掌红斑、手掌丘疹、抗 MDA5 抗体、ALT、天冬氨酸氨基转移酶（AST）、LDH 和 ESR 在 A/S-ILD 组的比例高于 CILD 组。手掌红斑和手掌丘疹是 A/S-ILD 的独立预测因素。手掌丘疹与抗 MDA5 抗体呈正相关。
发病年龄超过 56 岁、机械性手或肌肉无力预测 DM 相关 ILD 的发生，而手掌红斑或手掌丘疹可能预测潜在的 DM 相关 A/S-ILD。
