Polymyositis-dermatomyositis-associated interstitial lung disease

William W. Douglas, Henry D. Tazelaar, Thomas E. Hartman, Robert P. Hartman, Paul A. Decker, Darrell R. Schroeder, Jay H. Ryu

Research output: Contribution to journalArticle

427 Scopus citations

Abstract

We report findings in 70 patients with both diffuse interstitial lung disease and either polymyositis (PM) or dermatomyositis (DM). Initial presentations were most commonly either musculoskeletal (arthralgias, myalgias, and weakness) or pulmonary (cough, dyspnea, and fever) symptoms alone; in only 15 patients (21.4%) did both occur simultaneously. Pulmonary disease usually took the form of acute to subacute antibiotic-resistant community-acquired pneumonia. Chest radiographs and computed tomography most commonly demonstrated bilateral irregular linear opacities involving the lung bases; occasionally consolidation was present. Jo-1 antibody was present in 19 (38%) of 50 patients tested. Synchronous associated malignancy was present in 4 of 70 patients (5.7%). Surgical lung biopsies disclosed nonspecific interstitial pneumonia (NSIP) in 18 of 22 patients (81.8%), organizing diffuse alveolar damage (DAD) in 2, bronchiolitis obliterans organizing pneumonia (BOOP) in 1, and usual interstitial pneumonia (UIP) in 1. Treatment usually included prednisone in 40-60 mg/d dosages for initial control, followed by lower dose prednisone plus an immunosuppressive agent such as azathioprine or methotrexate for disease suppression. Survival was significantly better than that observed for historical control subjects with idiopathic UIP, and was more consistent with survival previously reported in idiopathic NSIP. There was no difference in survival between Jo-1 positive and Jo-1 negative groups.

Original languageEnglish (US)
Pages (from-to)1182-1185
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Volume164
Issue number7
DOIs
StatePublished - Oct 1 2001

Keywords

  • Azathioprine
  • Interstitial lung disease
  • Polymyositis-dermatomyositis
  • Prednisone
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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