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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


1, 2, 3, 4, 5, 6, 7

 

  1. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  2. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  3. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  4. College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
  5. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  6. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  7. Department of Rheumatology and Immunology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China. jian_jzhu@126.com

CER14114
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PMID: 33635220 [PubMed]

Received: 14/10/2020
Accepted : 25/01/2021
In Press: 15/02/2021

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.

Rheumatology Article