Mortality factors in idiopathic inflammatory myopathy: focusing on malignancy and interstitial lung disease
Jin-Hyun Woo1 , Yun Jung Kim2 , Jin Ju Kim3 , Chan-Bum Choi3 , Yoon-Kyoung Sung3 , Tae-Hwan Kim3 , Jae-Bum Jun3 , Sang-Cheol Bae3 , Dae-Hyun Yoo3
23 January 2012
10 May 2012
6 June 2012
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Objectives The objective of this study was to assess the incidence and common types of concomitant malignancies and to define predictive factors of death in Korean patients with idiopathic inflammatory myopathy (IIM).
Methods From January 1989 to May 2011, 162 patients were diagnosed with IIM at a university hospital in Korea. The medical records were retrospectively reviewed. The clinical findings of the patients were compared for malignancy, and the prognostic factors predicting death were analyzed.
Results Malignancies were found in 17 patients (10.5 %), all of whom had a significantly lower frequency of interstitial lung disease (ILD) and an older age at onset. The main causes of death were ILD and malignancy. Older age at diagnosis, presence of malignancy, rapidly progressive ILD and minimal creatinine phosphokinase (CPK) elevation were independent risk factors for death. Conclusions Malignancy was one of the most serious risk factor for death in our patients with IIM. Early discovery of malignancy is important, and an extensive investigation for common malignancies in each region should be done at diagnosis and for a minimum of 2 years thereafter. As minimally elevated CPK levels in ILD patients may be associated with fatal ILD, an early evaluation and a more aggressive treatment of ILD should be considered in these patients.
Death, Dermatomyositis, Malignancy, Polymyositis, Prognosis