Predicting Rapid Progression Of Dermatomyositis Associated Interstitial Lung Disease With HRCT

Objective:To detect if high-resolution computed tomography(HRCT)findings can assist in predicting the occurrence of rapid progressive interstitial lung disease(RP-ILD)in patients with dermatomyositis associated interstitial lung disease(DM-ILD).Method:We enrolled patients first diagnosed as DM-ILD in our hospital.All the patients were divided into two groups according to the occurrence of RP-ILD.Clinical data including manifestations,laboratory testing including C-reactive protein(CRP)and myositis specific antibodies(MSA)were collected.And the HRCT images were evaluated in a semi-quantitative way.The extent of affected up,mid and lower regions and the extent of each feature were calculated.The total scores were also calculated.All manifestations,laboratory testing and HRCT features and scores were compared between two groups.Anti-melanoma differentiation-associated gene 5(MDA5)positive patients were analyzed separately.Results:In all patient,all the manifestations,MSA were not significantly different in RPILD and non-RP-ILD group.CPR was significantly higher in RP-ILD group.In HRCT images,the extent of affected up region was significantly different between two groups.In anti-MDA5 antibody positive patients,All manifestations except heliotrope rash and laboratory testing were not significantly different.In HRCT images,the extent of affected up region was significantly different between two groups.The extent of other affected regions and features were not significantly different.Conclusion:The extent of affected up lung region in baseline HRCT is associated with the occurrence of RP-ILD in first diagnosed DM-ILD patients and DM-ILD patients with antiMDA5 antibody positive.