Full Papers
Elevated lactate dehydrogenase and co-infection: predictors of rapidly progressive interstitial lung disease and fatal outcomes in anti-MDA5-positive dermatomyositis
K. Qian1, M. Sheng2, W. Huang3, F. Ren4, D. Chen5, L. Tang6
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Rheumatology and Immunology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. hopetang@hospital.cqmu.edu.cn
CER19577
Full Papers
PMID: 43001858 [PubMed]
Received: 30/11/2025
Accepted : 21/04/2026
In Press: 30/10/2026
Abstract
OBJECTIVES:
To identify predictors of adverse outcomes in hospitalised patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM).
METHODS:
We retrospectively analysed data from 113 anti-MDA5+ DM patients during their first hospitalisation, including clinical features, season of onset, high-resolution computed tomography (HRCT) and laboratory results.
RESULTS:
Patients presenting primarily with respiratory symptoms had a significantly poorer prognosis than those with skin/muscle symptoms (p<0.05). Onset in winter/spring was associated with higher co-infection rates (p<0.05), and co-infected patients had higher rates of rapidly progressive interstitial lung disease (RP-ILD) or death (p<0.05). Serum lactate dehydrogenase (LDH) levels were significantly higher in patients with RP-ILD or death (p<0.05).
CONCLUSIONS:
Respiratory symptoms, co-infection, and elevated LDH (≥ 324.5 IU/L) are independent risk factors for RP-ILD or death in anti-MDA5+ DM. For newly hospitalised patients, detailed symptom assessment, prompt infection screening (especially with winter/spring onset) and close LDH monitoring are crucial for prognosis evaluation and guiding clinical management.
