Clinical impact of antineutrophil cytoplasmic antibody positivity on the occurrence of interstitial lung disease in patients with polymyositis/dermatomyositis

Jang Woo Ha, Jung Yoon Pyo, Sung Soo Ahn, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
2022
This study investigated the clinical impact of antineutrophil cytoplasmic antibody (ANCA) positivity on the occurrence of interstitial lung disease (ILD) in patients with probable and definite polymyositis (PM)/dermatomyositis (DM) who met both the Bohan and Peter and the 2017 European League Against Rheumatism/American College of Rheumatology criteria. The medical records of 75 PM/DM patients were retrospectively reviewed. ANCA and antiJo 1 positivity at diagnosis were obtained, and pulmonary
more » ... unction test and chest high-resolution computed tomography results at ILD occurrence were collected. The follow-up duration based on ILD was defined as the period from the time of PM/DM diagnosis to the occurrence of ILD in PM/DM patients with ILD and to the last visit for those without ILD. The median age was 50.0 years and 21.3% were male. ANCA and anti-Jo 1 were detected in 12 (16.0%) and 26 patients (34.7%), respectively. ILD occurred in 32 patients, 24 of whom had ILD at the time of PM/DM diagnosis. Anti-Jo 1 was detected more often in PM/DM patients without ANCA than those with (39.7% vs. 8.3%). ILD occurred more frequently in PM/DM patients with ANCA than those without ANCA (75.0% vs. 36.5%). However, the occurrence of ILD was not affected by anti-Jo 1 positivity. Furthermore, ANCA-positive PM/DM patients exhibited a significantly lower cumulative ILD-free survival rate than ANCA-negative PM/DM patients (P=0.009). ANCA positivity at the time of PM/DM diagnosis might be an important risk factor for ILD in PM/DM patients.
doi:10.21037/apm-22-604 pmid:36226644 fatcat:2kxt4n2jkbdzbbzbd2opk77ap4