Full Papers
Clinical manifestations and outcome of anti-aminoacyl-transfer RNA synthetase antibody and anti-melanoma differentiation-associated gene 5 antibody positive patients with interstitial lung disease
L. Feng1, H. Wang2, Y. Zhao3, T. Zhao4, J. Zhang5, F. Huang6, J. Zhu7
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
- College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
- Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China. jian_jzhu@126.com
CER14114
2022 Vol.40, N°1
PI 0097, PF 0103
Full Papers
PMID: 33635220 [PubMed]
Received: 14/10/2020
Accepted : 25/01/2021
In Press: 15/02/2021
Published: 28/01/2022
Abstract
OBJECTIVES:
To analyse the clinical features and risk factors of acute/subacute interstitial pneumonia (A/SIP) and death in patients with positive anti-aminoacyl-transfer RNA synthetase antibody (anti-ARS Ab) and positive anti-melanoma differentiation-associated gene 5 antibodies (anti-MDA5 Ab).
METHODS:
Interstitial lung disease (ILD) patients with anti-ARS+ or anti-MDA5+ were recruited. Their demographics, clinical manifestations, laboratory data were collected and they were followed up for 1 year. Risk factors of A/SIP and mortality were analysed.
RESULTS:
71 patients with anti-ARS+ ILD and 31 patients with anti-MDA5+ ILD were included. Incidence of ulcerative rash, Gottron’s sign, pulmonary infection and A/SIP in the anti-MDA5+ group were significantly higher than those in the anti-ARS+ group, Creatine kinase (CK), leukocyte count, and lymphocyte count were lower, the value of serum ferritin (SF) was higher, and 12-month cumulative survival rate was lower. Advanced age, anti-MDA5+ and low immunoglobulin G (IgG) level were independent predictors of A/SIP. The decreased PaO2 and elevated SF were independent predictors for poor prognosis in A/SIP patients.
CONCLUSIONS:
Compared to anti-ARS+ group, the anti-MDA5+ group was more prone to ulcerative rash, Gottron’s sign and pulmonary infection. Patients with anti-MDA5+, advanced age and decreased values of IgG were more likely to have A/SIP, while patients with A/SIP had lower incidence of myositis and arthritis. Mortality of A/SIP patients increased with higher serum ferritin level.
