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Interstitial Lung Disease in Anti–Jo‐1 Patients With Antisynthetase Syndrome
Author(s) -
Marie I.,
Josse S.,
Hatron P. Y.,
Dominique S.,
Hachulla E.,
Janvresse A.,
Cherin P.,
Mouthon L.,
Vittecoq O.,
Menard J.F.,
Jouen F.
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21895
Subject(s) - medicine , interstitial lung disease , antisynthetase syndrome , high resolution computed tomography , asymptomatic , pulmonary function testing , lung , radiology , surgery
Objective To assess the outcome of interstitial lung disease (ILD) in anti–Jo‐1 patients with antisynthetase syndrome, determine predictive variables of ILD deterioration in these patients, and compare features of anti–Jo‐1 patients with and without ILD. Methods Ninety‐one anti–Jo‐1 patients were identified by medical records search in 4 medical centers. All of these patients had undergone pulmonary function tests (PFTs) and high‐resolution computed tomography (HRCT) scans. Results Sixty‐six patients (72.5%) had ILD. Patients could be divided into 3 groups according to their presenting lung manifestations: acute onset of lung disease (n = 12), progressive onset of lung signs (n = 35), and asymptomatic patients exhibiting abnormalities consistent with ILD on PFTs and HRCT scans (n = 19). Sixteen patients had resolution of ILD; 39 and 11 patients experienced improvement and deterioration of ILD, respectively. ILD led to decreased functional status, since 29.8% of patients exhibited a marked reduction of activities due to ILD and 13.6% had respiratory insufficiency requiring oxygen therapy; 5 of 6 patients died due to ILD complications. Predictive parameters of ILD deterioration were HRCT scan pattern of usual interstitial pneumonia, respiratory muscle involvement, and age ≥55 years. Furthermore, anti–Jo‐1 patients with ILD, compared with those without, more frequently exhibited mechanic's hands and lower creatine kinase levels. Conclusion Our findings confirm that ILD is a frequent complication in anti–Jo‐1 patients, resulting in high morbidity. We suggest that patients with predictive factors of ILD deterioration may require more aggressive therapy. Finally, anti–Jo‐1 patients with ILD, compared with those without, may exhibit a particular clinical phenotype.