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Infection is not rare in patients with idiopathic inflammatory myopathies


1, 2, 3, 4, 5

 

  1. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
  2. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
  3. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
  4. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
  5. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China. luxin_n@163.com

CER14770
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PMID: 34369354 [PubMed]

Received: 01/05/2021
Accepted : 21/06/2021
In Press: 21/07/2021

Abstract

OBJECTIVES:
To assess the prevalence and characteristics of infections in patients with idiopathic inflammatory myopathies (IIM) and analyse risk factors for infection using clinical presentation and biochemical findings of IIM.
METHODS:
Retrospective review of the medical records of patients with IIM followed up in a single medical centre from January 2008 to January 2018.
RESULTS:
Of the 779 patients with IIM, 215 (27.6%) suffered from infections. The prevalence of infection in dermatomyositis (DM) (29.8%) was more than polymyositis (PM) (18.5%). The lung was the most common infection site (66.5%). Multivariate analyses demonstrated that methylprednisolone pulse (MP) (OR=3.22; 95% CI=1.60 - 6.48; p=0.001), age of onset >50 years (OR=1.02; 95% CI=1.00 - 1.03; p=0.011), anti-melanoma differentiation-associated gene 5 (MDA5) antibody (OR=1.93; 95% CI=1.20 - 3.11; p=0.007), lymphocyte count <1200/mm3 (OR=2.85; 95% CI=1.89 - 4.30; p<0.001), and interstitial lung diseases (ILD) (OR=2.03; 95% CI=1.30 - 3.71; p=0.002) are independent risk factors for infection. Survival analysis demonstrated that the three-year survival rate in the infection group was lower than the no-infection group (75.3% vs. 94.7%, p < 0.001).
CONCLUSIONS:
Among hospitalised individuals with IIM, infection is frequent and the leading cause of mortality. The anti-MDA5 antibody, lymphopenia, ILD, old age, and treatment with MP are contributing factors in the development of infections in patients with IIM.

Rheumatology Article