Clinical Differences Between Interstitial Lung Disease Associated With Clinically Amyopathic Dermatomyositis and Classic Dermatomyositis
|
|
- Lionel Jackson
- 6 years ago
- Views:
Transcription
1 CHEST Clinical Differences Between Interstitial Lung Disease Associated With Clinically Amyopathic Dermatomyositis and Classic Dermatomyositis Hiroshi Mukae, MD, PhD; Hiroshi Ishimoto, MD; Noriho Sakamoto, MD; Shintaro Hara, MD; Tomoyuki Kakugawa, MD; Seiko Nakayama, MD; Yuji Ishimatsu, MD; Atsushi Kawakami, MD; Katsumi Eguchi, MD; and Shigeru Kohno, MD, FCCP Original Research INTERSTITIAL LUNG DISEASE Background: Interstitial lung disease (ILD) associated with clinically amyopathic dermatomyositis (CADM) is a potentially fatal condition in which the clinical features are not well understood. The aim of the present study was to clarify the differences in clinical characteristics and prognosis of patients with ILD associated with CADM (CADM-ILD) and classic dermatomyositis associated with ILD (DM-ILD). Methods: We retrospectively studied consecutive patients with CADM-ILD and classic DM-ILD who were hospitalized between 2001 and 2007 at Nagasaki University Hospital. The study group consisted of 11 patients with CADM-ILD and 16 patients with classic DM-ILD. We compared the clinical features and prognosis between the two forms. Results: The PaO 2 /FIO 2 ratio was significantly lower in patients with CADM-ILD than in patients with classic DM-ILD. The lymphocyte subsets ratio in the BAL fluid of patients with CADM-ILD was significantly higher than the corresponding ratio in patients with classic DM-ILD. ILD is classified as acute or chronic, and the acute subtype was more common in patients with CADM-ILD than in those with classic DM-ILD. The mortality rate for patients with CADM-ILD (45%) was much higher than that for patients with classic DM-ILD (6%), and all of the CADM deaths occurred in the group of patients with acute CADM-ILD. Conclusion: Our data suggest that the higher prevalence of the acute subtype of ILD in patients with CADM results in a higher mortality rate for patients with CADM-ILD. (CHEST 2009; 136: ) Abbreviations: CADM clinically amyopathic dermatomyositis; CADM-ILD clinically amyopathic dermatomyositis associated with interstitial lung disease; CTD-ILD interstitial lung disease associated with connective tissue disease; DM-ILD dermatomyositis associated with interstitial lung disease; ILD interstitial lung disease; PMX polymyxin B immobilized fiber Interstitial lung disease (ILD) frequently occurs in patients with connective tissue diseases such as dermatomyositis and polymyositis. 1,2 In patients with dermatomyositis and polymyositis, ILD is a complication with a prevalence of 5% to 65%. 3 Although Manuscript received November 22, 2008; revision accepted June 18, Affiliations: From the Second Department of Internal Medicine (Drs. Mukae, Ishimoto, Sakamoto, Hara, Kakugawa, Nakayama, Ishimatsu, and Kohno), the First Department of Internal Medicine (Drs. Kawakami and Eguchi), and the Department of General Medicine (Dr. Nakayama), Nagasaki University School of Medicine, Nagasaki, Japan. the clinical features of ILD associated with connective tissue disease (CTD-ILD) are similar to those of idiopathic interstitial pneumonias, the survival rate of patients with CTD-ILD is much greater, and Correspondence to: Hiroshi Mukae, MD, PhD, Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Nagasaki , Japan; hmukae@nagasaki-u.ac.jp 2009 American College of Chest Physicians. Reproduction of this article is prohibited without written permission from the American College of Chest Physicians ( misc/reprints.xhtml). DOI: /chest CHEST / 136 / 5/ NOVEMBER,
2 more than one-half of the patients have a chronic indolent course. 4 However, certain patients with CTD-ILD have a rapidly progressive and fatal form of ILD. In particular, a subset of patients with clinically amyopathic dermatomyositis (CADM), which is defined by the criteria of Sontheimer 5 and Sontheimer and Miyagawa, 6 experiences a fulminant and devastating course These patients are often resistant to intensive therapy, such as high-dose corticosteroids and immunosuppressive agents, resulting in fatal respiratory failure. As CADM associated with ILD (CADM-ILD) is a rare condition, its characteristics have not been fully clarified. In the present study, we examined a series of patients with CADM-ILD to determine its clinical features and prognosis compared with those of classic dermatomyositis associated with ILD (DM-ILD). Materials and Methods Patient and Diagnostic Criteria We retrospectively studied 27 consecutive Japanese patients with CADM and classic DM-ILD who were hospitalized at the Nagasaki University Hospital from 2001 to This hospital is a referral center in this area for ILD. All patients were referred to our hospital for the evaluation of dermatomyositisassociated ILD. Some patients were admitted to the hospital for diagnostic evaluation in the absence of clinical deterioration, whereas others were admitted for the evaluation of respiratory failure. Amyopathic dermatomyositis is characterized by Gottron rash or heliotrope rash, normal creatine kinase levels and muscle biopsy results, and no symptoms or signs of muscle weakness. Hypomyopathic dermatomyositis is characterized by Gottron rash or heliotrope rash, no symptoms of muscle weakness, and normal or only mildly reduced muscle strength consistent with age, sex, and severity of systemic illness. 11 CADM is the combination of amyopathic and hypomyopathic dermatomyositis. 5,13 While the definition by Sontheimer 5 requires that skin disease be present for 6 months without the development of muscle disease, Sontheimer and Miyagawa 6 have also described a subset of patients with premyopathic dermatomyositis in whom fatal ILD developed within the first 6 months of their disease course. They included these patients in their review of CADM-ILD because the cases represented ILD occurring in a patient with dermatomyositis-specific skin disease in the absence of muscle disease. Our study population consisted of patients who fulfilled the traditional criteria of Sontheimer 5 and Bohan and Peter 14,15 and a group of patients who fit into the category of premyopathic dermatomyositis. ILD was diagnosed based on the presence of radiologic abnormalities in chest radiographs and helical CT scans. CADM and classic dermatomyositis were diagnosed by skin biopsy or by evaluation by a Japan College of Rheumatology-certified rheumatologist and a dermatologist (A.K. and K.E.), with consistent features found on examination. Clinical data, including history, treatment, laboratory findings, and BAL fluid findings, were obtained from the patients medical records. The Human Ethics Review Committees of Nagasaki University School of Medicine approved the study protocol, and all living participants provided written consent. Two patients in this study have already been described in a case report (case 3 8 and case 6 16 in patients with CADM-ILD). Scoring of Helical CT Scan Findings The helical CT findings were graded on a scale of 1 to 6 on the basis of the classification system previously reported by Ichikado and colleagues 17,18 as follows: (1) normal attenuation; (2) groundglass attenuation; (3) consolidation; (4) ground-glass attenuation with traction bronchiolectasis or bronchiectasis; (5) consolidation with traction bronchiolectasis or bronchiectasis; and (6) honeycombing. The presence of each of these six abnormalities was assessed independently in three zones (upper, middle, and lower) of each lung. The extent of each abnormality was determined by visually estimating the percentage (to the nearest 10%) of the affected lung parenchyma in each zone. The assessments of three observers were averaged. The abnormality score for each zone was calculated by multiplying the percentage area by the point value (score of 1 to 6). The six zone scores were averaged to determine the total score for each abnormality in each patient. The overall CT scan score for each patient was obtained by adding the six averaged scores. Statistical Analysis Values are expressed as the mean SD for continuous variables and as percentages for categorical variables. We performed statistical analyses with a computer software package (StatMate III for Macintosh, version 3.14; ATMS Co, Ltd; Tokyo, Japan). We used the Wilcoxon test to compare continuous variables, and the 2 test or Fisher exact test to compare categorical variables. Cumulative survival probabilities were estimated by using the Kaplan-Meier method. The log-rank test was used to compare the survival of groups of patients. A p value 0.05 was considered statistically significant, and all tests were two tailed. Results Clinical Features and Laboratory Findings Eleven patients (two men and nine women; mean [ SD] age, years; current smokers, two patients; never-smokers, nine patients) were given a diagnosis of CADM-ILD, and 16 patients (one man and 15 women; mean age, years; neversmokers, 16 patients) were given a diagnosis of classic DM-ILD. There were no statistically significant differences in the male/female ratio and the age distribution between CADM and classic dermatomyositis. No patients had any malignancies or pulmonary infection. Two patients with CADM (one patient treated with methotrexate and corticosteroid, and one patient treated with corticosteroid) and nine patients with dermatomyositis (seven patients treated with corticosteroid and cyclosporine, and two patients treated with corticosteroid) received treatment before hospital admission. Skin biopsies had been performed in 6 of the 11 patients with CADM and in 10 of the 16 patients with classic dermatomyositis; the pathologic findings were consistent with a diagnosis of dermatomyositis Original Research
3 Table 1 Comparison of Clinical Characteristics Between With CADM-ILD and With Classic Dermatomyositis Characteristics CADM-ILD (n 11) Classic DM-ILD (n 16) p Value WBC count, cells/ L C-reactive protein, NS mg/dl Lactate NS dehydrogenase, U/L Creatine kinase, NS U/mL KL-6, U/mL NS Pao 2 /Fio 2 ratio, mm Hg Data are presented as the mean SD, unless otherwise indicated. NS not significant. The mean duration of respiratory and/or skin symptoms before hospital admission was significantly shorter for CADM-ILD patients ( months) than for classic DM-ILD patients ( months; p 0.001). Skin symptoms preceded respiratory symptoms in 4 of 11 patients (36%) with CADM-ILD and in 7 of 16 patients (44%) with classic DM-ILD. The onset of pulmonary symptoms was concomitant with the onset of skin symptoms in 6 of the 11 patients (55%) with CADM-ILD and in 5 of 16 patients (31%) with classic DM-ILD. Solitary respiratory manifestations preceded any skin disease in one patient (9%) with CADM-ILD and in four patients (25%) with classic DM-ILD. with CADM-ILD and classic DM-ILD were classified as having the acute type or chronic type based on their clinical presentation. The acute type included patients in whom skin and respiratory symptoms developed within 2 months prior to admission to our hospital. Seven patients (64%) with CADM-ILD and three patients (19%) with classic DM-ILD were given a diagnosis of acute-type disease. Thus, a higher prevalence of acute-type disease was found in patients with CADM-ILD (p 0.05). Laboratory findings are summarized in Table 1. WBC counts were significantly greater in patients with classic dermatomyositis than in patients with CADM. Both groups had elevated levels of serum C-reactive protein, lactate dehydrogenase, and KL-6, but there were no significant differences between the two groups (Table 1). Antinuclear antibodies were present in 4 of 10 patients with CADM-ILD and in 11 of 13 patients with classic DM-ILD. Tests for anti-jo-1 antibody were negative in all patients with CADM-ILD; however, 5 of 16 patients with classic DM-ILD had positive results (Table 2). Pao 2 / Fio 2 ratio at hospital admission was significantly lower in patients with CADM-ILD than in patients with classic DM-ILD (Table 1). CT Scan Findings and the CT Scan Score CT scan images of the lung were available for all patients. Images from all patients showed groundglass opacities. Consolidation was more common in patients with CADM (Fig 1), as has been found in previous reports. 9,10 Helical CT scan images of the lung were available for 24 of 27 patients. We calculated the CT scan score in these 24 patients. The CT scan score is predictive of poor prognosis in patients with ARDS and acute interstitial pneumonia. 17,18 There was no significant difference in the CT scan score between patients with CADM-ILD (153 38) and patients with classic DM-ILD (133 24). However, in the CADM-ILD group, the CT scan score correlated inversely with Pao 2 /Fio 2 ratio (r ; p 0.001) [Fig 2]. BAL Fluid Analysis BAL was performed in 7 patients with CADM and 11 patients with classic dermatomyositis. There were no significant differences in the number of total cells or the percentage of inflammatory cells between the two groups (Table 3). However, patients with CADM-ILD had a significantly higher lymphocyte subset (CD4 / CD8 ) ratio than patients with classic DM-ILD. Treatment All patients received therapy with corticosteroids. Seven patients with classic DM-ILD received therapy with corticosteroids alone, achieving a good effect, while therapy with corticosteroids alone did not provide improvement in any of the patients with CADM-ILD (Table 2). Immunosuppressive agents such as cyclosporine, methotrexate, cyclophosphamide, and tacrolimus were added to corticosteroid therapy in all patients with CADM-ILD and in eight patients with classic DM-ILD. Treatment with immunosuppressive agents and corticosteroids was effective in 5 of 11 patients with CADM-ILD and in 6 of 16 patients with classic DM-ILD. In addition, IV Ig agents were administered to two patients with classic DM-ILD. Three patients received leukocytapheresis, and two patients received treatment with a direct hemoperfusion column containing polymyxin B immobilized fibers (PMXs). Mortality and Survival During the observation period, 5 of the 11 patients (45%) with CADM-ILD died. These five patients CHEST / 136 / 5/ NOVEMBER,
4 Table 2 Clinical Characteristics of the CADM and Classic DM-ILD Cases Age, yr Sex Symptoms, mo Treatment Respiratory Skin Acute/ Chronic Anti-Jo1 Corticosteroids Cyclosporin A Others Outcome CADM-ILD 1 45 Female 1 1 Acute Cyclophosphamide Death 2 74 Female 1 1 Acute Cyclophosphamide Alive 3 49 Male 1 2 Acute Cyclophosphamide Death 4 74 Female Acute Death 5 69 Female 2 2 Acute PMX, Leukocytapheresis Death 6 70 Male 6 6 Chronic PMX Alive 7 53 Female Chronic Alive 8 67 Female 12 1 Chronic Cyclophosphamide Alive 9 57 Female 1 12 Chronic Tacrolimus, Cyclophosphamide Alive Female 1 1 Acute Tacrolimus, Cyclophosphamide, Death Leukocytapheresis Female 1 1 Acute Alive Classic DM-ILD 1 57 Female 29 3 Chronic IVIG Alive 2 63 Female 4 3 Chronic Alive 3 31 Female 2 9 Chronic Alive 4 52 Female 1 8 Chronic Tacrolimus Alive 5 62 Female Chronic Alive 6 65 Female 1 1 Acute Alive 7 30 Female 2 5 Chronic Alive 8 59 Female 48 7 Chronic Death 9 45 Female Chronic Leukocytapheresis Alive Male Chronic Alive Female Chronic Cyclophosphamide Alive Female Chronic Methotrexate Alive Female Chronic IVIG, Cyclophosphamide Alive Female 2 4 Chronic Alive Female 2 2 Acute Tacrolimus Alive Female 1 1 Acute Alive IVIG IV high-dose Ig; negative; positive. had acute-type disease that followed a fulminant course with rapid progression of respiratory failure, and they died within 1 to 2 months (Table 2, Fig 3). The mortality rate for patients with the acute type of CADM-ILD was extremely high (5 of 7; 71%), while no patients with chronic-type CADM-ILD died. There were no significant differences in the male/ female ratio, age distribution, WBC counts, serum KL-6 levels, and CD4 /CD8 ratio in BAL fluid between survivors and nonsurvivors with CADM- ILD (data not shown). In contrast, 1 of the 16 patients (6%) with classic DM-ILD died; respiratory failure developed in this patient 4 years after disease presentation. Thus, the mortality rate for patients Figure 1. A representative CT scan of a patient with CADM- ILD (case 1) shows consolidation and ground-glass opacities predominantly in the subpleural region. Figure 2. Correlation between the CT scan score and Pao 2 /Fio 2 ratio in patients with CADM-ILD and classic DM-ILD Original Research
5 Table 3 Comparison of BAL Fluid Findings Between With CADM-ILD and With Classic DM-ILD Variables CADM-ILD (n 7) with CADM-ILD was significantly higher than that for patients with classic DM-ILD (p 0.02). Discussion Classical DM-ILD (n 11) p Value Total cells, 10 5 cells/ml NS Macrophages, % NS Neutrophils, % NS Eosinophils, % NS Lymphocytes, % NS CD4 /CD8 ratio Data are presented as the mean SD, unless otherwise indicated. See Table 1 for abbreviation not used in the text. Figure 3. Overall survival curves of patients with CADM-ILD and classic DM-ILD. Time indicates the number of months since the onset of respiratory or skin symptoms. CADM is a rare form of dermatomyositis that typically manifests with characteristic cutaneous lesions and mild or no muscle involvement. 5,13 Cottin et al 19 reported a favorable prognosis for patients with CADM-ILD, but there have been reports, 6 10 mainly from Asian regions, of several cases of fatal ILD associated with CADM. These observations suggest that CADM includes heterogeneous disease populations. The present study showed that the mortality rate of patients with CADM-ILD was significantly higher than that of patients with classic DM-ILD and that the acute type of ILD is more frequent in patients with CADM-ILD compared with those with classic DM-ILD. We also found that five of seven patients (71%) with acute type CADM- ILD died, while none of the patients with chronictype CADM-ILD died; these findings are consistent with previous reports. 9,10 The mortality rate for patients with chronic CADM-ILD has been shown to be similar to that of patients with classic DM-ILD. We tried to use laboratory results to find a better way of characterizing patients with CADM-ILD, especially patients with acute-type disease. However, there were no significant differences between patients with CADM-ILD and those with classic DM- ILD, except for high WBC counts, low Pao 2 /Fio 2 ratio (Table 1), and the absence of anti-jo-1 antibody (Table 2) in CADM-ILD compared with patients with classic DM-ILD. Although KL-6 was previously reported to be a useful marker for ILD in patients with dermatomyositis and polymyositis, 20 it did not have prognostic significance in the present study. We next examined characteristics of chest CT scan features of CADM-ILD. This is the first report to describe quantitative CT scan scores in patients with CADM-ILD compared with those of patients with classic DM-ILD. The few previous studies of CT scan findings from patients with CADM-ILD 9,10 have often reported ground-glass opacities, consolidation, and reticular opacities in these patients; these characteristics have also been found in patients with classic DM-ILD. 21,22 The CT scan findings in the present study are consistent with these reports; the CT scan score was inversely correlated with Pao 2 / Fio 2 ratio only in patients with CADM-ILD (Fig 2), suggesting that it may be useful in patients with CADM-ILD. The BAL results indicate that the CD4 /CD8 ratio is greater in CADM patients than in those with classic dermatomyositis. An increased percentage of CD8 lymphocytes (cytotoxic T cells) was previously found in BAL fluid from patients with DM- ILD. 23 Kurasawa et al 24 reported that the number of CD25 CD4 and CD25 CD8 T cells in the BAL fluid of patients with dermatomyositis was significantly greater in patients with corticosteroidresistant interstitial pneumonia than in patients with corticosteroid-sensitive interstitial pneumonia. While little is known about the BAL findings of patients with CADM-ILD, Suda et al 9 demonstrated that the CD4 /CD8 ratio in BAL fluid tended to be higher in patients with acute-type CADM-ILD. Ito et al 25 found a higher CD4 /CD8 ratio in the peripheral blood and BAL fluid of patients with dermatomyositis with rapidly progressive ILD. The findings of these previous reports were consistent with our present data, which suggests a different immune reaction in the lung between CADM-ILD and classic DM-ILD patients. In this study, all patients received corticosteroids, and seven patients with classic DM-ILD who received corticosteroids alone achieved a good re- CHEST / 136 / 5/ NOVEMBER,
6 sponse. However, corticosteroids alone did not improve the condition of any patients with CADM- ILD. Immunosuppressive agents, such as cyclosporine, were needed in all patients with CADM-ILD and 8 of the 16 patients with classic DM-ILD. However, five of seven patients with acute-type CADM-ILD died despite the treatment; this high mortality rate suggests that the current therapy is not sufficient for acute-type CADM-ILD. Miyazaki et al 12 reported a case of diffuse alveolar damage in a patient with rapidly progressive CADM-ILD that was successfully treated with an early intervention of corticosteroids, cyclosporine, and pulse cyclophosphamide. In addition to immunosuppressants, PMX treatment has been reported 26,27 to improve oxygenation in patients with ARDS and acute exacerbation of idiopathic pulmonary fibrosis. We encountered a patient with CADM-ILD (case 6) who was successfully treated with PMX. 16 Future studies are needed to elucidate a new effective therapy for acutetype CADM-ILD. In conclusion, our data suggest that the higher prevalence of the acute subtype of ILD in patients with CADM results in a higher mortality rate for patients with CADM-ILD. However, our present study is limited by the small number of patients. In addition, there is ascertainment bias toward patients who are sick enough to warrant referral to our hospital, and milder or subclinical cases are unlikely to be included. Acknowledgments Author contributions: Dr. Mukae designed the article, acquired the data, analyzed and interpreted the data, and drafted the article. Drs. Ishimoto, Sakamoto, Hara, Kakugawa, Nakayama, Ishimatsu, and Kawakami acquired the data, interpreted the data, and helped draft the article. Drs. Eguchi and Kohno interpreted the data and helped draft the article. Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. References 1 Tazelaar HD, Viggiano RW, Pickersgill J, et al. Interstitial lung disease in polymyositis and dermatomyositis: clinical features and prognosis as correlated with histologic findings. Am Rev Respir Dis 1990; 141: Marie I, Hachulla E, Cherin P, et al. Interstitial lung disease in polymyositis and dermatomyositis. Arthritis Rheum 2002; 47: Fathi M, Lundberg IE. Interstitial lung disease in polymyositis and dermatomyositis. Curr Opin Rheumatol 2005; 17: Park JH, Kim DS, Park IN, et al. Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease-related subtypes. Am J Respir Crit Care Med 2007; 175: Sontheimer RD. Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis sine myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness? J Am Acad Dermatol 2002; 46: Sontheimer RD, Miyagawa S. Potentially fatal interstitial lung disease can occur in clinically amyopathic dermatomyositis. J Am Acad Dermatol 2003; 48: Lee CS, Chen TL, Tzen CY, et al. Idiopathic inflammatory myopathy with diffuse alveolar damage. Clin Rheumatol 2002; 21: Sakamoto N, Mukae H, Fujii T, et al. Nonspecific interstitial pneumonia with poor prognosis associated with amyopathic dermatomyositis. Intern Med 2004; 43: Suda T, Fujisawa T, Enomoto N, et al. Interstitial lung diseases associated with amyopathic dermatomyositis. Eur Respir J 2006; 28: Ideura G, Hanaoka M, Koizumi T, et al. Interstitial lung disease associated with amyopathic dermatomyositis: review of 18 cases. Respir Med 2007; 101: Ye S, Chen XX, Lu XY, et al. Adult clinically amyopathic dermatomyositis with rapid progressive interstitial lung disease: a retrospective cohort study. Clin Rheumatol 2007; 26: Miyazaki E, Ando M, Muramatsu T, et al. Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis. Clin Rheumatol 2007; 26: Sontheimer RD. Cutaneous features of classic dermatomyositis and amyopathic dermatomyositis. Curr Opin Rheumatol 1999; 11: Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975; 292: Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975; 292: Kakugawa T, Mukae H, Saito M, et al. Rapidly progressive interstitial pneumonia associated with clinically amyopathic dermatomyositis successfully treated with polymyxin B-immobilized fiber column hemoperfusion. Intern Med 2008; 47: Ichikado K, Suga M, Muranaka H, et al. Prediction of prognosis for acute respiratory distress syndrome with thinsection CT: validation in 44 cases. Radiology 2006; 238: Ichikado K, Suga M, Muller NL, et al. Acute interstitial pneumonia: comparison of high-resolution computed tomography findings between survivors and nonsurvivors. Am J Respir Crit Care Med 2002; 165: Cottin V, Thivolet-Bejui F, Reynaud-Gaubert M, et al. Interstitial lung disease in amyopathic dermatomyositis, dermatomyositis and polymyositis. Eur Respir J 2003; 22: Bandoh S, Fujita J, Ohtsuki Y, et al. Sequential changes of KL-6 in sera of patients with interstitial pneumonia associated with polymyositis/dermatomyositis. Ann Rheum Dis 2000; 59: Arakawa H, Yamada H, Kurihara Y, et al. Nonspecific interstitial pneumonia associated with polymyositis and dermatomyositis: serial high-resolution CT findings and functional correlation. Chest 2003; 123: Bonnefoy O, Ferretti G, Calaque O, et al. Serial chest CT findings in interstitial lung disease associated with polymyositis-dermatomyositis. Eur J Radiol 2004; 49: Kourakata H, Takada T, Suzuki E, et al. Flow cytometric analysis of bronchoalveolar lavage fluid cells in polymyositis/ dermatomyositis with interstitial pneumonia. Respirology 1999; 4: Original Research
7 24 Kurasawa K, Nawata Y, Takabayashi K, et al. Activation of pulmonary T cells in corticosteroid-resistant and -sensitive interstitial pneumonitis in dermatomyositis/polymyositis. Clin Exp Immunol 2002; 129: Ito M, Kaise S, Suzuki S, et al. Clinico-laboratory characteristics of patients with dermatomyositis accompanied by rapidly progressive interstitial lung disease. Clin Rheumatol 1999; 18: Seo Y, Abe S, Kurahara M, et al. Beneficial effect of polymyxin B-immobilized fiber column (PMX) hemoperfusion treatment on acute exacerbation of idiopathic pulmonary fibrosis. Intern Med 2006; 45: Cruz DN, Perazella MA, Bellomo R, et al. Effectiveness of polymyxin B-immobilized fiber column in sepsis: a systematic review. Crit Care 2007; 11:R47 CHEST / 136 / 5/ NOVEMBER,
PL-7 and Anti-Jo-1 Antibodies. publication is available at link.sp
NAOSITE: Nagasaki University's Ac Title Author(s) Comparison of Pulmonary Involvement PL-7 and Anti-Jo-1 Antibodies Tomonaga, Masaomi; Sakamoto, Noriho Tomoyuki; Harada, Tatsuhiko; Nakash Shintaro; Horai,
More informationCASE REPORT. Abstract. Introduction. Case Report
CASE REPORT Rapidly Progressive Interstitial Pneumonia Associated with Clinically Amyopathic Dermatomyositis Successfully Treated with Polymyxin B-immobilized Fiber Column Hemoperfusion Tomoyuki Kakugawa
More informationInterstitial lung diseases associated with amyopathic dermatomyositis
Eur Respir J 2006; 28: 1005 1012 DOI: 10.1183/09031936.06.00038806 CopyrightßERS Journals Ltd 2006 Interstitial lung diseases associated with amyopathic dermatomyositis T. Suda*, T. Fujisawa*, N. Enomoto*,
More informationKey words: CT scanners; interstitial lung diseases; polymyositis-dermatomyositis; x-ray
Nonspecific Interstitial Pneumonia Associated With Polymyositis and Dermatomyositis* Serial High-Resolution CT Findings and Functional Correlation Hiroaki Arakawa, MD; Hidehiro Yamada, MD; Yasuyuki Kurihara,
More informationInterstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis
Rheumatology Advance Access published June 21, 2005 Rheumatology 2005; 1 of 5 doi:10.1093/rheumatology/keh723 Concise Report Interstitial lung disease in patients with polymyositis, dermatomyositis and
More informationClinical significance of serum surfactant protein D (SP-D) in patients with polymyositisudermatomyositis: correlation with interstitial lung disease
Rheumatology 2002;41:1268 1272 Clinical significance of serum surfactant protein D (SP-D) in patients with polymyositisudermatomyositis: correlation with interstitial lung disease H. Ihn, Y. Asano, M.
More informationCTD-related Lung Disease
13 th Cambridge Chest Meeting King s College, Cambridge April 2015 Imaging of CTD-related Lung Disease Dr Sujal R Desai King s College Hospital, London Disclosure Statement No Disclosures / Conflicts of
More informationCASE REPORT. Introduction. Case Report
doi: 10.2169/internalmedicine.9553-17 http://internmed.jp CASE REPORT Successful Treatment of Rapidly Progressive Unclassifiable Idiopathic Interstitial Pneumonia with Anti-melanoma Differentiation-associated
More informationClinical Features of Anti-MDA5 Antibody-positive Rapidly Progressive Interstitial Lung Disease without Signs of Dermatomyositis
doi: 10.2169/internalmedicine.1516-18 http://internmed.jp CASE REPORT Clinical Features of Anti-MDA5 Antibody-positive Rapidly Progressive Interstitial Lung Disease without Signs of Dermatomyositis Noriho
More informationmyopathy and interstitial lung dise
NAOSITE: Nagasaki University's Ac Title Author(s) Citation A case of primary Sjögren's syndrom myopathy and interstitial lung dise Koga, Tomohiro; Kouhisa, Yukiko; Na Akinari; Motomura, Masakatsu; Kawak
More informationInterstitial lung disease in clinically amyopathic dermatomyositis with and without anti-mda-5 antibody: to lump or split?
Ikeda et al. BMC Pulmonary Medicine (2015) 15:159 DOI 10.1186/s12890-015-0154-4 RESEARCH ARTICLE Open Access Interstitial lung disease in clinically amyopathic dermatomyositis with and without anti-mda-5
More informationConnective Tissue Disorder- Associated Interstitial Lung Disease (CTD-ILD) and Updates
Connective Tissue Disorder- Associated Interstitial Lung Disease (CTD-ILD) and Updates Maria Elena Vega, M.D Assistant Professor of Medicine Lewis Katz School of Medicine at Temple University Nothing to
More informationSTUDY. Interstitial Lung Disease in Classic and Skin-Predominant Dermatomyositis. A Retrospective Study With Screening Recommendations
STUDY Interstitial Lung Disease in Classic and Skin-Predominant Dermatomyositis A Retrospective Study With Screening Recommendations Pamela A. Morganroth, MD; Mary Elizabeth Kreider, MD, MSCE; Joyce Okawa,
More informationNew respiratory symptoms and lung imaging findings in a woman with polymyositis
Maria Bolaki 1, Konstantinos Karagiannis 1, George Bertsias 2, Ioanna Mitrouska 1, Nikolaos Tzanakis 1, Katerina M. Antoniou 1 kantoniou@uoc.gr 1 Dept of Thoracic Medicine, Heraklion University Hospital,
More informationDermatomyositis with Rapidly Progressive Interstitial Lung Disease Treated with Rituximab: A Report of 3 Cases in Japan
CASE REPORT Dermatomyositis with Rapidly Progressive Interstitial Lung Disease Treated with Rituximab: A Report of 3 Cases in Japan Kenichiro Tokunaga 1 and Noboru Hagino 2 Abstract We performed a retrospective
More informationdermatomyositis: report of a case.
Living-donor lobar lung transplanta Titleinterstitial pneumonia associated w dermatomyositis: report of a case., Tsuyoshi; Bando, Toru; Fujin Author(s) Fengshi; Sasano, Hajime; Yukawa, Na Tsuneyo; Date,
More informationDifferential diagnosis
Differential diagnosis Idiopathic pulmonary fibrosis (IPF) is part of a large family of idiopathic interstitial pneumonias (IIP), one of four subgroups of interstitial lung disease (ILD). Differential
More informationINTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018
INTERSTITIAL LUNG DISEASE Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 Interstitial Lung Disease Interstitial Lung Disease Prevalence by Diagnosis: Idiopathic Interstitial
More informationLiebow and Carrington's original classification of IIP
Liebow and Carrington's original classification of IIP-- 1969 Eric J. Stern MD University of Washington UIP Usual interstitial pneumonia DIP Desquamative interstitial pneumonia BIP Bronchiolitis obliterans
More informationComparison of clinical course of polymyositis and dermatomyositis :a follow-up study in Tokushima University
9 ORIGINAL Comparison of clinical course of polymyositis and dermatomyositis :a follow-up study in Tokushima University Hospital Kenji Tani, Reiko Tomioka,KeikoSato, Chiyuki Furukawa, Takeshi Nakajima,
More informationPulmonary manifestations of CTDs Diagnosis, differential diagnosis and treatment
Prague, June 2014 Pulmonary manifestations of CTDs Diagnosis, differential diagnosis and treatment Katerina M. Antoniou, MD, PhD As. Professor in Thoracic Medicine ERS ILD Group Secretary Medical School,
More informationPrognostic Factors in the Acute Exacerbation of Idiopathic Pulmonary Fibrosis: A Retrospective Single-center Study
doi: 10.2169/internalmedicine.9331-17 Intern Med Advance Publication http://internmed.jp ORIGINAL ARTICLE Prognostic Factors in the Acute Exacerbation of Idiopathic Pulmonary Fibrosis: A Retrospective
More informationThe Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (2), Page
The Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (2), Page 1135-1140 Role of High Resolution Computed Tomography in Diagnosis of Interstitial Lung Diseases in Patients with Collagen Diseases
More informationNONE OVERVIEW FINANCIAL DISCLOSURES UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF (UIP) FOR PATHOLOGISTS. IPF = Idiopathic UIP Radiologic UIP Path UIP
UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF () FOR PATHOLOGISTS Thomas V. Colby, M.D. Professor of Pathology (Emeritus) Mayo Clinic Arizona FINANCIAL DISCLOSURES NONE OVERVIEW IPF Radiologic Dx Pathologic
More informationInternational consensus statement on idiopathic pulmonary fibrosis
Eur Respir J 2001; 17: 163 167 Printed in UK all rights reserved Copyright #ERS Journals Ltd 2001 European Respiratory Journal ISSN 0903-1936 PERSPECTIVE International consensus statement on idiopathic
More informationCombined Unclassifiable Interstitial Pneumonia and Emphysema: A Report of Two Cases
CASE REPORT Combined Unclassifiable Interstitial Pneumonia and Emphysema: A Report of Two Cases Nobuhiko Nagata 1, Kentaro Watanabe 2, Michihiro Yoshimi 3, Hiroshi Okabayashi 4, Katsuo Sueishi 5, Kentaro
More informationInterstitial lung disease and anti-jo-1 antibodies: difference between acute and gradual onset
1 Service de Pneumologie et Réanimation Respiratoire, Hôpital Tenon, Paris, France; 2 Service de Pneumologie, Hôpital Avicenne, Bobigny, France; 3 Service de Pneumologie, Hôpital Bichat, Paris, France;
More informationSequential changes of KL-6 in sera of patients with interstitial pneumonia associated with polymyositis/dermatomyositis
Ann Rheum Dis 2;59:257 262 257 EXTENDED REPORTS First Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan S Bandoh J Fujita Y Ueda S Hojo M Tokuda H Dobashi J Takahara Kinashi Ohbayashi
More informationIdiopathic non-specific interstitial pneumonia: as an autoimmune interstitial pneumonia
Respiratory Medicine (2005) 99, 234 240 Idiopathic non-specific interstitial pneumonia: as an autoimmune interstitial pneumonia Jiro Fujita a,, Yuji Ohtsuki b, Takeo Yoshinouchi c, Ichiro Yamadori d, Shuji
More informationInfluence of Smoking in Interstitial Pneumonia Presenting with a Non-Specific Interstitial Pneumonia Pattern
ORIGINAL ARTICLE Influence of Smoking in Interstitial Pneumonia Presenting with a Non-Specific Interstitial Pneumonia Pattern Tetsuro Sawata, Masashi Bando, Masayuki Nakayama, Naoko Mato, Hideaki Yamasawa
More informationAccumulation of periostin in acute exacerbation of familial idiopathic pulmonary fibrosis
Case Report Accumulation of periostin in acute exacerbation of familial idiopathic pulmonary fibrosis Keisuke Murata 1, Yasuhiko Koga 1, Norimitsu Kasahara 1, Yoshimasa Hachisu 1, Satoshi Nunomura 2, Nozomi
More informationLong-term efficacy of macrolide treatment in idiopathic pulmonary fibrosis: a retrospective analysis
Original article: Clinical research SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2016; 33; 242-246 Mattioli 1885 Long-term efficacy of macrolide treatment in idiopathic pulmonary fibrosis: a retrospective
More information11/10/2014. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. Radiology
Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective Radiology Pathology Clinical 1 Role of HRCT Diagnosis Fibrosis vs. inflammation Next step in management Response to treatment
More informationHYPERSENSITIVITY PNEUMONITIS
HYPERSENSITIVITY PNEUMONITIS A preventable fibrosis MOSAVIR ANSARIE MB., FCCP INTERSTITIAL LUNG DISEASES A heterogeneous group of non infectious, non malignant diffuse parenchymal disorders of the lower
More informationThe Onset of Eosinophilic Pneumonia Preceding Anti-synthetase Syndrome
doi: 10.2169/internalmedicine.8955-17 http://internmed.jp CASE REPORT The Onset of Eosinophilic Pneumonia Preceding Anti-synthetase Syndrome Yoshimasa Hachisu 1, Yasuhiko Koga 1, Noriaki Sunaga 1,2, Chiharu
More informationEvidence Review: Title. Month/ Year. Evidence Review:
Evidence Review: Title Month/ Year Evidence Review: Rituximab for connective tissue disease associated interstitial lung disease October 2014 Standard Operating Procedure: NHS England Evidence Review:
More informationJune 2013 Pulmonary Case of the Month: Diagnosis Makes a Difference. Lewis J. Wesselius, MD 1 Henry D. Tazelaar, MD 2
June 2013 Pulmonary Case of the Month: Diagnosis Makes a Difference Lewis J. Wesselius, MD 1 Henry D. Tazelaar, MD 2 Departments of Pulmonary Medicine 1 and Laboratory Medicine and Pathology 2 Mayo Clinic
More informationClinical features of seven Japanese patients with anti-pl- antibody frequent positivity for anti-cyclic citrullinated peptide antibody
Cace report Clinical features of seven Japanese patients with anti-pl- antibody frequent positivity for anti-cyclic citrullinated peptide antibody Yoichiro Akiyama 1, Takao Nagashima 1, Masahiro Iwamoto
More informationFinancial disclosure COMMON DIAGNOSES IN HRCT. High Res Chest HRCT. HRCT Pre test. I have no financial relationships to disclose. Anatomy Nomenclature
Financial disclosure I have no financial relationships to disclose. Douglas Johnson D.O. Cardiothoracic Imaging Gaston Radiology COMMON DIAGNOSES IN HRCT High Res Chest Anatomy Nomenclature HRCT Sampling
More informationIPF: Epidemiologia e stato dell arte
IPF: Epidemiologia e stato dell arte Clinical Classification Diffuse parenchimal lung diseases Exposure-related: - occupational - environmental - medication Desquamative interstitial pneumonia Idiopathic
More informationAutoantibodies in the Idiopathic Inflammatory Myopathies
Autoantibodies in the Idiopathic Inflammatory Myopathies Steven R. Ytterberg, M.D. Division of Rheumatology Mayo Clinic Rochester, MN The Myositis Association Annual Conference St. Louis, MO Sept. 25,
More informationMalignancies in Korean Patients with Inflammatory Myopathy
Yonsei Medical Journal Vol. 47, No. 4, pp. 519-523, 2006 Malignancies in Korean Patients with Inflammatory Myopathy Sang-Won Lee, Sang Youn Jung, Min-Chan Park, Yong-Beom Park, and Soo-Kon Lee Division
More informationAsymmetry in acute exacerbation of idiopathic pulmonary fibrosis
ORIGINAL ARTICLE IDIOPATHIC PULMONARY FIBROSIS Asymmetry in acute exacerbation of idiopathic pulmonary fibrosis Akihiko Sokai 1, Kiminobu Tanizawa 2, Tomohiro Handa 1, Takeshi Kubo 3, Seishu Hashimoto
More informationIs ARDS Important to Recognize?
Is ARDS Important to Recognize? Lorraine B. Ware MD Vanderbilt University Financial Disclosures: research funding from Boehringer Ingelheim, Global Blood Therapeutics Why diagnose ARDS? -initiate specific
More informationAcute Respiratory Distress Syndrome as the Initial Clinical Manifestation of an Antisynthetase Syndrome
CASE REPORT http://dx.doi.org/10.4046/trd.2016.79.3.188 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2016;79:188-192 Acute Respiratory Distress Syndrome as the Initial Clinical Manifestation
More informationUsual interstitial pneumonia in rheumatoid arthritis-associated interstitial lung disease
Eur Respir J 2010; 35: 1322 1328 DOI: 10.1183/09031936.00092309 CopyrightßERS 2010 Usual interstitial pneumonia in rheumatoid arthritis-associated interstitial lung disease E.J. Kim*, B.M. Elicker #, F.
More information5/9/2015. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. No, I am not a pulmonologist! Radiology
Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective No, I am not a pulmonologist! Radiology Pathology Clinical 1 Everyone needs a CT Confidence in diagnosis Definitive HRCT +
More informationCryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus
Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus Poster No.: C-1622 Congress: ECR 2012 Type: Scientific Exhibit Authors: C. Cordero Lares, E. Zorita
More informationDiffuse Interstitial Lung Diseases: Is There Really Anything New?
: Is There Really Anything New? Sujal R. Desai, MBBS, MD ESTI SPEAKER SUNDAY Society of Thoracic Radiology San Antonio, Texas March 2014 Diffuse Interstitial Lung Disease The State of Play DILDs Is There
More informationThoracic lung involvement in rheumatoid arthritis: Findings on HRCT
Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Poster No.: C-2488 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. J. Martín Sánchez, J. M. Fernandez 1 1
More informationMyositis and Your Lungs
Myositis and Your Lungs 2013 TMA Annual Patient Meeting Louisville, Kentucky Chester V. Oddis, MD University of Pittsburgh Director, Myositis Center Myositis Heterogeneous group of autoimmune syndromes
More informationIdiopathic inflammatory myopathies
Myositis and cancer Idiopathic inflammatory myopathies Primary idiopathic polymyositis Primary idiopathic dermatomyositis Juvenile poly/dermatomyositis Myositis associated with another CTD Myositis associated
More informationORIGINAL ARTICLE Immunology, Allergic Disorders & Rheumatology INTRODUCTION MATERIALS AND METHODS
ORIGINAL ARTICLE Immunology, Allergic Disorders & Rheumatology http://dx.doi.org/1.3346/jkms.216.31.3.389 J Korean Med Sci 216; 31: 389-396 Elevated Erythrocyte Sedimentation Rate Is Predictive of Interstitial
More informationPrevalence and reactivity of anti-melanoma differentiation-associated gene 5 (anti-mda-5) autoantibody in Brazilian patients with dermatomyositis *
Investigation 517 Particular characteristics Soares de Sá BC, of atopic Moredo eczema LF, Gomes in tropical EE, de environments. Araújo ESS, Duprat The Tropical JP Environment... 517 s Prevalence and reactivity
More informationUSEFULNESS OF HRCT IN DIAGNOSIS AND FOLLOW UP OF PULMONARY INVOLVEMENT IN SYSTEMIC SCLEROSIS
USEFULNESS OF HRCT IN DIAGNOSIS AND FOLLOW UP OF PULMONARY INVOLVEMENT IN SYSTEMIC SCLEROSIS Brestas P., Vergadis V., Emmanouil E., Malagari K. 2 nd Dept of Radiology, University of Athens, Greece ABSTRACT
More informationOriginal Article A clinical analysis of prognostic factors for dermatomyositis-associated interstitial lung disease
Int J Clin Exp Med 2018;11(6):5903-5911 www.ijcem.com /ISSN:1940-5901/IJCEM0066897 Original Article A clinical analysis of prognostic factors for dermatomyositis-associated interstitial lung disease Ti
More informationACUTE RESPIRATORY DISTRESS SYNDROME
ACUTE RESPIRATORY DISTRESS SYNDROME Angel Coz MD, FCCP, DCE Assistant Professor of Medicine UCSF Fresno November 4, 2017 No disclosures OBJECTIVES Identify current trends and risk factors of ARDS Describe
More informationTBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than
TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than PAP) BAL is not required as a diagnostic tool in patients
More informationNOTICE OF SUBSTANTIAL AMENDMENT
NOTICE OF SUBSTANTIAL AMENDMENT For use in the case of all research other than clinical trials of investigational medicinal products (CTIMPs). For substantial amendments to CTIMPs, please use the EU-approved
More informationTreatment of Coccidioidomycosis-associated Eosinophilic Pneumonia with Corticosteroids
Treatment of Coccidioidomycosis-associated Eosinophilic Pneumonia with Corticosteroids Joshua Malo, MD Yuval Raz, MD Linda Snyder, MD Kenneth Knox, MD University of Arizona Medical Center Department of
More informationHRCT in Diffuse Interstitial Lung Disease Steps in High Resolution CT Diagnosis. Where are the lymphatics? Anatomic distribution
Steps in High Resolution CT Diagnosis Pattern of abnormality Distribution of disease Associated findings Clinical history Tomás Franquet MD What is the diagnosis? Hospital de Sant Pau. Barcelona Secondary
More informationClinical Study A Clinical Analysis of Risk Factors for Interstitial Lung Disease in Patients with Idiopathic Inflammatory Myopathy
Clinical and Developmental Immunology Volume 2013, Article ID 648570, 4 pages http://dx.doi.org/10.1155/2013/648570 Clinical Study A Clinical Analysis of Risk Factors for Interstitial Lung Disease in Patients
More informationImaging findings in Hypersensitivity Pneumonitis - a pictorical review.
Imaging findings in Hypersensitivity Pneumonitis - a pictorical review. Poster No.: C-1655 Congress: ECR 2014 Type: Educational Exhibit Authors: B. M. Araujo, A. F. S. Simões, M. S. C. Rodrigues, J. Pereira;
More informationIdiopathic interstitial pneumonias (IIPs) are a group of
SYMPOSIA C. Isabela S. Silva, MD, PhD and Nestor L. Müller, MD, PhD Abstract: The idiopathic interstitial pneumonias (IIPs) are a group of diffuse parenchymal lung diseases of unknown etiology characterized
More informationImaging Cancer Treatment Complications in the Chest
Imaging Cancer Treatment Complications in the Chest Michelle S. Ginsberg, MD Objectives Imaging Cancer Treatment Complications in the Chest To understand the mechanisms of action of different classes of
More informationOutline Definition of Terms: Lexicon. Traction Bronchiectasis
HRCT OF IDIOPATHIC INTERSTITIAL PNEUMONIAS Disclosures Genentech, Inc. Speakers Bureau Tadashi Allen, MD University of Minnesota Assistant Professor Diagnostic Radiology 10/29/2016 Outline Definition of
More informationARDS - a must know. Page 1 of 14
ARDS - a must know Poster No.: C-1683 Congress: ECR 2016 Type: Authors: Keywords: DOI: Educational Exhibit M. Cristian; Turda/RO Education and training, Edema, Acute, Localisation, Education, Digital radiography,
More informationTitle:Pemetrexed for advanced non-small cell lung cancer patients with interstitial lung disease
Author's response to reviews Title:Pemetrexed for advanced non-small cell lung cancer patients with interstitial lung disease Authors: Motoyasu Kato (mtkatou@juntendo.ac.jp) Takehito Shukuya (tshukuya@juntendo.ac.jp)
More informationIPF - Inquadramento clinico
IPF - Inquadramento clinico Sergio Harari Unità Operativa di Pneumologia UTIR Servizio di Fisiopat. Resp. e Emodinamica Polmonare Ospedale S. Giuseppe, Milano Clinical Classification Diffuse parenchimal
More informationIdiopathic inflammatory myopathies and the lung
EUROPEAN RESPIRATORY UPDATE IDIOPATHIC INFLAMMATORY MYOPATHIES Idiopathic inflammatory myopathies and the lung Jean-Christophe Lega 1,2, Quitterie Reynaud 1, Alexandre Belot 3, Nicole Fabien 4, Isabelle
More informationElevated α-defensin levels in plasma and bronchoalveolar lavage fluid from patients with myositis-associated interstitial lung disease
Sakamoto et al. BMC Pulmonary Medicine (2018) 18:44 https://doi.org/10.1186/s12890-018-0609-5 RESEARCH ARTICLE Open Access Elevated α-defensin levels in plasma and bronchoalveolar lavage fluid from patients
More informationCase 4 History. 58 yo man presented with prox IP joint swelling 2 months later pain and swelling in multiple joints Chest radiograph: bi-basilar
Case 4 History 58 yo man presented with prox IP joint swelling 2 months later pain and swelling in multiple joints Chest radiograph: bi-basilar basilar infiltrates suggestive of pulmonary fibrosis Open
More informationA case of a patient with IPF treated with nintedanib. Prof. Kreuter and Prof. Heussel
A case of a patient with IPF treated with nintedanib Prof. Kreuter and Prof. Heussel Case Overview This case describes the history of a patient with IPF who, at the time of diagnosis, had symptoms typical
More informationLung Allograft Dysfunction
Lung Allograft Dysfunction Carlos S. Restrepo M.D. Ameya Baxi M.D. Department of Radiology University of Texas Health San Antonio Disclaimer: We do not have any conflict of interest or financial gain to
More informationa SpringerOpen Journal
Ikeda et al. SpringerPlus (2015) 4:240 DOI 10.1186/s40064-015-1013-8 a SpringerOpen Journal RESEARCH Open Access Incidence and impact of interstitial lung disease and malignancy in patients with polymyositis,
More information4/17/2010 C ini n ca c l a Ev E a v l a ua u t a ion o n of o ILD U dat a e t e i n I LDs
Update in ILDs Diagnosis 101: Clinical Evaluation April 17, 2010 Jay H. Ryu, MD Mayo Clinic, Rochester MN Clinical Evaluation of ILD Outline General aspects of ILDs Classification of ILDs Clinical evaluation
More informationBronchoalveolar Lavage and Histopathologic Diagnosis Based on Biopsy
Idiopathic Pulmonary Fibrosis Bronchoalveolar Lavage and Histopathologic Diagnosis Based on Biopsy JMAJ 46(11): 469 474, 2003 Yukihiko SUGIYAMA Professor, Division of Pulmonary Medicine, Department of
More informationPulmonary Manifestations of the Idiopathic Inflammatory Myopathies
Pulmonary Manifestations of the Idiopathic Inflammatory Myopathies Meena Kalluri, MD a, *, Chester V. Oddis, MD b KEYWORDS Myositis Pulmonary complications Interstitial lung disease The idiopathic inflammatory
More informationNaomi Yoshida, Shinjiro Kaieda, Kumi Tomozoe, Morihiro Tajiri, Daisuke Wakasugi, Masaki Okamoto, Masaki Tominaga, Hiroaki Ida and Tomoaki Hoshino
CASE REPORT An Autopsy Case of Anti-melanoma Differentiation-associated Gene-5 Antibody-positive Clinical Amyopathic Dermatomyositis Complicated by Rapidly Progressive Interstitial Lung Disease Naomi Yoshida,
More informationDermatomyositis Advice from Experts: Improving Your Medical Dermatology Diagnostic and Management Skills Jeffrey P. Callen, MD Professor of Medicine
Dermatomyositis Advice from Experts: Improving Your Medical Dermatology Diagnostic and Management Skills Jeffrey P. Callen, MD Professor of Medicine (Dermatology) University of Louisville Learning Objectives
More informationIntravenous cyclophosphamide therapy for progressive interstitial pneumonia in patients with polymyositis/ dermatomyositis
Rheumatology 2007;46:124 130 Advance Access publication 4 June 2006 Intravenous cyclophosphamide therapy for progressive interstitial pneumonia in patients with polymyositis/ dermatomyositis Y. Yamasaki
More informationUsual Interstitial pneumonia and Nonspecific Interstitial Pneumonia. Nitra and the Gangs.
Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia Nitra and the Gangs. บทน ำและบทท ๓, ๑๐, ๑๒, ๑๓, ๑๔, ๑๕, ๑๗ Usual Interstitial Pneumonia (UIP) Most common & basic pathologic pattern
More informationPrognostic Significance of Histopathologic Subsets in Idiopathic Pulmonary Fibrosis
Prognostic Significance of Histopathologic Subsets in Idiopathic Pulmonary Fibrosis JULIE A. BJORAKER, JAY H. RYU, MARK K. EDWIN, JEFFREY L. MYERS, HENRY D. TAZELAAR, DARRELL R. SCHROEDER, and KENNETH
More informationDAILY SCREENING FORM
DAILY SCREENING FORM Patient s initials: Date of admission: Time of admission: Gender: M F Year of Birth: Type of admission: Medical/Surgical/Postoperative (elective) Days Date Mechanical ventilation Lung
More informationImaging: how to recognise idiopathic pulmonary fibrosis
REVIEW IDIOPATHIC PULMONARY FIBROSIS Imaging: how to recognise idiopathic pulmonary fibrosis Anand Devaraj Affiliations: Dept of Radiology, St George s Hospital, London, UK. Correspondence: Anand Devaraj,
More informationOverview of Diagnostic Autoantibodies in Inflammatory Myopathy
Overview of Diagnostic Autoantibodies in Inflammatory Myopathy Minoru Satoh, M.D., Ph.D. Research Associate Professor of Medicine Division of Rheumatology and Clinical Immunology University of Florida
More informationDisclosures. Fibrotic lung diseases: Basic Principles, Common Problems, and Reporting. Relevant financial relationships: None. Off-label usage: None
Fibrotic lung diseases: Basic Principles, Common Problems, and Reporting Brandon T. Larsen, MD, PhD Senior Associate Consultant Department of Laboratory Medicine and Pathology Mayo Clinic Arizona Arizona
More informationAutoantibodies to a 140-kd Polypeptide, CADM-140, in Japanese Patients With Clinically Amyopathic Dermatomyositis
ARTHRITIS & RHEUMATISM Vol. 52, No. 5, May 2005, pp 1571 1576 DOI 10.1002/art.21023 2005, American College of Rheumatology Autoantibodies to a 140-kd Polypeptide, CADM-140, in Japanese Patients With Clinically
More information4/16/2018. Demystifying weakness: how to approach refractory myositis. Objectives. Disclosures. Off-label uses for medications will be discussed
Demystifying weakness: how to approach refractory myositis Jemima Albayda, MD Assistant Professor Johns Hopkins Myositis center Disclosures Off-label uses for medications will be discussed Objectives To
More informationI n 2002 the American Thoracic Society (ATS) and
1008 REVIEW SERIES Challenges in pulmonary fibrosis? 5: The NSIP/UIP debate Roland du Bois, Talmadge E King Jr... Among the idiopathic interstitial s, the two entities idiopathic pulmonary fibrosis (IPF)
More information2009 H1N1 Influenza Infection: Spectrum Of Chest CT Findings, With Radiologic- Pathologic Correlation
ISPUB.COM The Internet Journal of Radiology Volume 12 Number 2 2009 H1N1 Influenza Infection: Spectrum Of Chest CT Findings, With Radiologic- Pathologic Correlation A Nachiappan, E Weihe, B Akkanti, V
More informationAcute exacerbation of interstitial pneumonia associated with collagen vascular diseases
Respiratory Medicine (2009) 103, 846e853 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed Acute exacerbation of interstitial pneumonia associated with collagen vascular
More informationNon-neoplastic Lung Disease II
Pathobasic Non-neoplastic Lung Disease II Spasenija Savic Prince Pathology Program Systematic approach to surgical lung biopsies with ILD Examples (chronic ILD): Idiopathic interstitial pneumonias: UIP,
More informationRapidly Progressive Interstitial Lung Disease in a
CASE REPORT Rapidly Progressive Interstitial Lung Disease in a Dermatomyositis Patient with High Levels of Creatine Phosphokinase, Severe Muscle Symptomsand Positive Anti-Jo-1 Antibody Kosuke Kashiwabara
More informationDisappearance of anti-mda-5 autoantibodies in clinically amyopathic DM/interstitial lung disease during disease remission
RHEUMATOLOGY Rheumatology 2012;51:800 804 doi:10.1093/rheumatology/ker408 Advance Access publication 30 December 2011 Concise report Disappearance of anti-mda-5 autoantibodies in clinically amyopathic
More informationInterstitial Lung Disease in Polymyositis and Dermatomyositis
Arthritis & Rheumatism (Arthritis Care & Research) Vol. 47, No. 6, December 15, 2002, pp 614 622 DOI 10.1002/art.10794 2002, American College of Rheumatology ORIGINAL ARTICLE Interstitial Lung Disease
More informationProgress in Idiopathic Pulmonary Fibrosis
Progress in Idiopathic Pulmonary Fibrosis David A. Lynch, MB Disclosures Progress in Idiopathic Pulmonary Fibrosis David A Lynch, MB Consultant: t Research support: Perceptive Imaging Boehringer Ingelheim
More informationChanges in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation
Eur Respir J 2007; 29: 453 461 DOI: 10.1183/09031936.00015506 CopyrightßERS Journals Ltd 2007 Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after
More informationHSP47 in lung fibroblasts is a predictor of survival in fibrotic nonspecific interstitial pneumonia
Respiratory Medicine (2010) 104, 895e901 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed HSP47 in lung fibroblasts is a predictor of survival in fibrotic nonspecific interstitial
More information