Objective: To explore the clinical features, predictive factors and unfavourable prognostic factors of interstitial lung disease (ILD) in the patients with polymyositis and dermatomyositis (PM/DM) so as to provide rationales for early clinical diagnosis and treatment.
Methods: The medical records of 244 PM/DM patients from Department of Rheumatology & Immunology of Anhui Medical University Affiliated Provincial Hospital from August 2001 to August 2011 were reviewed to analyze the clinical features, predictive factors and unfavourable prognostic factors of ILD in PM/DM patients.
Results: The major clinical manifestations of PM/DM-ILD included dry cough, chest tightness and shortness of breath during activities and Velcro rale in lower lung. Besides anti-Jo-1 antibody, multivariate unconditional Logistic regression analysis indicated that amyopathic dermatomyositis (ADM), arthralgia/arthritis, fever and Gottron's sign were the predictive factors for the development of ILD in PM/DM patients. ADM and Hamman-Rich-like pattern ILD were the poor prognostic factors while large dose glucocorticoids plus immunosuppressant therapy in the early time was a protective factor for PM/DM-ILD patients.
Conclusion: Some clinical features are the predictive factors for the development of ILD. ADM and Hamman-Rich-like pattern ILD are poor prognostic factors. Large dose glucocorticoids plus immunosuppressant therapy can significantly improve the prognosis of PM/DM patients.