TY - JOUR T1 - Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. JF - The Journal of Rheumatology JO - J Rheumatol SP - 58 LP - 64 VL - 32 IS - 1 AU - Tomoyuki Fujisawa AU - Takafumi Suda AU - Yutaro Nakamura AU - Noriyuki Enomoto AU - Kyotaro Ide AU - Mikio Toyoshima AU - Hiroshi Uchiyama AU - Ryoji Tamura AU - Masaaki Ida AU - Takeshi Yagi AU - Kazumasa Yasuda AU - Hitoshi Genma AU - Hiroshi Hayakawa AU - Kingo Chida AU - Hirotoshi Nakamura Y1 - 2005/01/01 UR - http://www.jrheum.org/content/32/1/58.abstract N2 - OBJECTIVE: To assess the difference in clinical features and prognosis of patients with interstitial lung disease (ILD) comparing polymyositis (PM) and dermatomyositis (DM). METHODS: Medical records of 28 ILD patients with PM/DM (16 PM-ILD, 12 DM-ILD) were reviewed retrospectively. RESULTS: Serum CPK concentrations were significantly higher in PM-ILD than in DM-ILD. Bronchoalveolar lavage analysis showed that the percentages of lymphocytes and eosinophils were significantly higher in DM-ILD than in PM-ILD. Ten patients (5 PM-ILD, 5 DM-ILD) underwent surgical lung biopsy, and 3 (3 DM-ILD) had an autopsy. Nonspecific interstitial pneumonia (NSIP) was found in 7 (4 PM-ILD, 3 DM-ILD) and usual interstitial pneumonia (UIP) in 3 (1 PM-ILD, 2 DM-ILD). Interestingly, diffuse alveolar damage (DAD) was found in 3 patients with DM-ILD, who all died of deterioration of ILD; but no one with PM-ILD had DAD. Corticosteroid treatment alone achieved a favorable response in 6 patients (37.5%) with PM-ILD, but in only one (8.3%) with DM-ILD. Administration of cyclosporine in the early phase of onset benefited 4 corticosteroid-resistant patients with DM-ILD. Conclusively, survival in DM-ILD was significantly worse than that in PM-ILD. CONCLUSION: DM-ILD is more refractory to corticosteroid therapy, resulting in poorer prognosis compared with PM-ILD. These data indicate that intensive therapy, including cyclosporine, should be considered for DM-ILD. ER -