OBJECTIVES: We retrospectively investigated clinical prognostic factors for interstitial pneumonia (IP) in anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM) patients.METHODS: Subjects comprised 18 patients with anti-MDA5 Ab-positive DM-IP (9 survivors; 9 deaths).RESULTS: Initial serum albumin levels, ferritin levels, and ground-glass opacity (GGO) scores in the right middle lobes were significantly higher in the death group than in the survivor group (p = .033, .013, and .005, respectively). Initial alveolar-arterial oxygen gradient (P[A-a]O2) was also higher in the death group than in the survivor group (p = .064). Initial serum ferritin, P[A-a]O2, and right middle lobe GGO score were found to significantly relate to death. Survival rates after 24 weeks were significantly lower among patients with an initial ferritin level of ?450 ng/mL (25%), P[A-a]O2 of ?30 mmHg (31%), and a right middle lobe GGO score of ?2 (11%) than each of the others (p = .006, .020, and .002, respectively).CONCLUSIONS: An initial serum ferritin level of ?450 ng/mL, P[A-a]O2 of ?30 mmHg, and right middle lobe GGO score of ?2 (GGO ?5% of the lobe) were identified as poor prognostic factors for anti-MDA5 Ab-positive DM-IP patients.
Adult Aged