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肌炎相关间质性肺疾病综述

A Review of Myositis-Associated Interstitial Lung Disease.

作者信息

Kannappan Renuka, Kumar Raagni, Cichelli Kimberly, Brent Lawrence H

机构信息

Department of Internal Medicine, Temple University Hospital, Philadelphia, PA 19140, USA.

Section of Rheumatology, Temple University Hospital, Philadelphia, PA 19140, USA.

出版信息

J Clin Med. 2024 Jul 11;13(14):4055. doi: 10.3390/jcm13144055.

Abstract

There is a well-established relationship between different subsets of idiopathic inflammatory myopathies (IIMs, myositis) and interstitial lung disease (ILD), with lung complications sometimes presenting prior to myopathic manifestations. The subtypes of myositis include those that are strongly associated with ILD, such as polymyositis (PM) and dermatomyositis (DM). Research has shown that in certain patients, these can then be further divided into subtypes using myositis-specific antibodies (MSAs), which are specific for myositis, and myositis-associated antibodies (MAAs), which can be found in myositis in overlap syndromes with other connective tissue diseases (CTDs). Notably, certain MSAs and MAAs are associated with ILD in patients with myositis. The clinical presentations of ILD in patients with myositis can vary widely and can be insidious in onset and difficult to diagnose. As ILD can progress rapidly in some cases, it is essential that clinicians are able to identify and diagnose ILD in patients with myositis. For this reason, the aim of this review is to highlight the clinical features, diagnostic criteria, important histopathologic, laboratory, and radiographic features, and treatment modalities for those patients with myositis-associated ILD.

摘要

特发性炎性肌病(IIMs,肌炎)的不同亚群与间质性肺疾病(ILD)之间存在着已被充分证实的关系,肺部并发症有时在肌病表现之前就会出现。肌炎的亚型包括那些与ILD密切相关的类型,如多发性肌炎(PM)和皮肌炎(DM)。研究表明,在某些患者中,这些类型随后可以使用肌炎特异性抗体(MSAs)进一步细分,MSAs是肌炎特有的,还有肌炎相关抗体(MAAs),后者可在与其他结缔组织病(CTDs)重叠综合征的肌炎患者中发现。值得注意的是,某些MSAs和MAAs与肌炎患者的ILD有关。肌炎患者中ILD的临床表现差异很大,起病可能隐匿且难以诊断。由于ILD在某些情况下可能迅速进展,临床医生能够识别和诊断肌炎患者中的ILD至关重要。因此,本综述的目的是强调肌炎相关ILD患者的临床特征、诊断标准、重要的组织病理学、实验室和影像学特征以及治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e24/11278012/75e869a8e6dd/jcm-13-04055-g001.jpg

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