Related Experiment Videos
[Prognosis of life in polymyositis/dermatomyositis]
K Murabayashi1, E Saito, S Okada
1Fourth Department of Internal Medicine, Ohashi Hospital, Toho University, Tokyo.
Abstract:
Although substantial patients are dead in the course of PM/DM, little papers have precisely investigated the cause of death and factors which may relate to death in PM/DM. The purpose of the present study is to evaluate the prognosis for life, causes of death and risk factors for life in PM/DM. Clinical records of 76 adult PM/DM patients were retrospectively reviewed. Seven patients died of associated malignancy. Five-year survival rate was 69.7% in PM/DM patients without malignancy. During the last 24 years, there was no significant change in survival rate. Among causes of death in 19 cases without malignancy, 7 cases died of respiratory failure and 7 patients died of cardiac involvement. There seems to be two types of pulmonary involvement causing respiratory failure; i.e. acute interstitial pneumonitis and chronic interstitial pneumonitis. In the former cases, the courses were very rapid, and patients died during 4 months after appearance of the first symptom. Risk factors were chosen by comparing clinical manifestation in dead patients with those in control subject. Control subjects were selected from non-dead patients by matching with sex, age, and duration after start of the first therapy. Acute onset disease, fever, arthritis, hypergammaglobulinemia, elevated ESR (greater than or equal to 30 mm/hr), lung fibrosis, and heart involvement are risk factors for life.
Insights
Polymyositis and dermatomyositis (PM/DM) patients face significant mortality, often from respiratory or cardiac issues. Acute onset, fever, and lung fibrosis are key risk factors impacting survival in these inflammatory myopathies.
Area of Science:
- Rheumatology
- Pulmonology
- Cardiology
Context:
- Polymyositis and dermatomyositis (PM/DM) are inflammatory myopathies with substantial patient mortality.
- Limited research precisely details causes of death and associated risk factors in PM/DM.
Purpose:
- To evaluate the prognosis, causes of death, and risk factors for mortality in adult patients with PM/DM.
- To identify clinical manifestations associated with increased risk of death.
Summary:
- Retrospective review of 76 adult PM/DM patients.
- Five-year survival rate was 69.7% in patients without malignancy.
- Respiratory failure (46%) and cardiac involvement (37%) were leading causes of death in non-malignant cases.
- Acute interstitial pneumonitis presented rapidly, leading to death within 4 months.
- Identified risk factors for mortality include acute onset, fever, arthritis, hypergammaglobulinemia, elevated ESR, lung fibrosis, and heart involvement.
Impact:
- Provides critical insights into PM/DM mortality patterns and survival rates.
- Highlights the importance of monitoring respiratory and cardiac function in PM/DM patients.
- Informs clinical practice for risk stratification and early intervention strategies to improve PM/DM patient outcomes.