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Pulmonary complications of polymyositis and dermatomyositis

Maryam Fathi1, Ingrid E Lundberg, Göran Tornling

  • 1Department of Medicine, Division of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.

Seminars in Respiratory and Critical Care Medicine
|September 4, 2007
PubMed

Insights

Polymyositis and dermatomyositis can cause serious lung issues, including interstitial lung disease (ILD). Early pulmonary evaluation is crucial for managing these inflammatory muscle diseases and their respiratory complications.

Area of Science:

  • Rheumatology
  • Pulmonology
  • Immunology

Background:

  • Polymyositis and dermatomyositis are systemic inflammatory myopathies with uncertain causes and outcomes.
  • Pulmonary complications, particularly interstitial lung disease (ILD), are significant contributors to morbidity and mortality in these conditions.
  • Respiratory symptoms are often unreliable indicators of ILD in myositis patients.

Purpose of the Study:

  • To highlight the importance of pulmonary evaluation in patients diagnosed with polymyositis or dermatomyositis.
  • To outline the spectrum of pulmonary complications associated with inflammatory myopathies.
  • To emphasize the diagnostic value of specific autoantibodies and imaging in detecting ILD.

Main Methods:

  • Review of literature on pulmonary involvement in polymyositis and dermatomyositis.
  • Categorization of pulmonary complications: aspiration pneumonia, hypoventilation, and ILD.
  • Identification of diagnostic tools including chest radiography, high-resolution computed tomography (HRCT), and pulmonary function tests (PFTs).

Main Results:

  • Interstitial lung disease (ILD) is a common pulmonary complication in myositis.
  • Anti-histidyl transfer RNA (tRNA) synthetase antibodies (anti-Jo-1) are the strongest predictors of ILD.
  • ILD can occur in myositis patients even in the absence of anti-Jo-1 antibodies.

Conclusions:

  • Comprehensive pulmonary assessment is essential for all patients with polymyositis or dermatomyositis.
  • Diagnostic workup should include chest imaging and lung function testing regardless of respiratory symptoms.
  • Early detection and management of ILD can improve outcomes in inflammatory myopathies.

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