Interstitial lung disease in polymyositis and dermatomyositis

Arthritis Rheum. 2002 Dec 15;47(6):614-22. doi: 10.1002/art.10794.


Objectives: To assess prevalence, characteristics, and long-term outcome of interstitial lung disease (ILD) in polymyositis (PM) and dermatomyositis (DM). To determine predictive variables of ILD course in PM/DM, and to define both clinical and biochemical features associated with ILD onset in PM/DM.

Methods: The medical records of 156 consecutive PM/DM patients in 3 medical centers were reviewed.

Results: Thirty-six PM/DM patients (23.1%) developed ILD. We observed that 19.4% of patients with ILD had resolution of pulmonary disorders, whereas 25% experienced ILD deterioration. Morbidity and mortality rates were as high as 13.9% and 36.4%, respectively, in PM/DM patients with ILD. Parameters of PM/DM that related to ILD poor outcome were identified as follows: Hamman-Rich-like pattern, initial diffusing capacity of carbon monoxide <45%, neutrophil alveolitis, and histologic usual interstitial pneumonia. Additionally, for the group with ILD, polyarthritis, higher values of erythrocyte sedimentation rate and C-reactive protein, presence of anti-Jo-1 antibody, and characteristic microangiopathy were significantly more frequent.

Conclusion: Our series underlines the high frequency of ILD in PM/DM patients, resulting in increased morbidity and mortality rates. It also indicates that PM/DM patients should routinely be screened for ILD, even those patients without anti-Jo-1 antibody, because 69% of our ILD patients were seronegative for the anti-Jo-1 antibody. Our findings further suggest that PM/DM patients presenting with factors predictive of ILD poor outcome may require more aggressive therapy.

MeSH terms

  • Antibodies, Antinuclear / blood
  • Biopsy
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Dermatomyositis / immunology
  • Dermatomyositis / mortality*
  • Female
  • Humans
  • Lung Diseases, Interstitial / immunology
  • Lung Diseases, Interstitial / mortality*
  • Lung Diseases, Interstitial / pathology
  • Male
  • Middle Aged
  • Polymyositis / immunology
  • Polymyositis / mortality*
  • Predictive Value of Tests
  • Pulmonary Fibrosis / immunology
  • Pulmonary Fibrosis / mortality
  • Pulmonary Fibrosis / pathology
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Vanadates


  • Antibodies, Antinuclear
  • Jo-1 antibody
  • pervanadate
  • Vanadates
  • C-Reactive Protein