Two Patients with Polymyositis or Dermatomyositis Complicated with Massive Pleural Effusion.

Miyata, Masayuki; Fukaya, Etsuko; Takagi, Tadayuki; Watanabe, Kenya; Saito, Hiroyuki; Itô, Masayuki; Yoshioka, Ryoji; Kazuta, Y; Yusa, Yukie; Irisawa, Atsushi; Satô, Yukio; Nishimaki, Tomoe; Kumakawa, Hiromi; Kasukawa, Reiji

doi:10.2169/internalmedicine.37.1058

Cited by 18 publications

(7 citation statements)

References 7 publications

(2 reference statements)

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“…In a series of dermatomyositis-or polymyositis-related ILD the prevalence was estimated as 5% [86]. It may be isolated or associated with ILD or pericardial effusion [142][143][144]. A CTD-specific myocarditis with congestive failure must be ruled out in cases of transudate effusion [144].…”

Section: Pleural Effusionmentioning

confidence: 99%

Idiopathic inflammatory myopathies and the lung

et al. 2015

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Idiopathic inflammatory myositis (IIM) is a group of rare connective tissue diseases (CTDs) characterised by muscular and extramuscular signs, in which lung involvement is a challenging issue. Interstitial lung disease (ILD) is the hallmark of pulmonary involvement in IIM, and causes morbidity and mortality, resulting in an estimated excess mortality of 50% in some series. Except for inclusion body myositis, these extrapulmonary disorders are associated with the general and visceral involvement frequently found in other CTDs including fever, Raynaud's phenomenon, arthralgia, nonspecific cutaneous modifications and ILD, for which the prevalence is estimated to be up to 65%. Substantial heterogeneity exists within the spectrum of IIMs, and each condition is associated with various frequencies and subtypes of pulmonary involvement. This heterogeneity is partly related to the presence of various autoantibodies encompassing anti-synthetase, anti-MDA5 and anti-PM/Scl. ILD is present in all subsets of IIM including juvenile myositis, but is more frequent in dermatomyositis and overlap myositis. IIM can also be associated with other presentations of respiratory involvement, namely pulmonary arterial hypertension, pleural disease, infections, drug-induced toxicity, malignancy and respiratory muscle weakness. Here, we critically review the current knowledge about adult and juvenile myositis-associated lung disease with a detailed description of therapeutics for chronic and rapidly progressive ILD. @ERSpublications Interstitial lung disease is a leading cause of morbidity in dermatomyositis/polymyositis

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Section: Pleural Effusionmentioning

confidence: 99%

Idiopathic inflammatory myopathies and the lung

et al. 2015

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“…None of 65 patients with polymyositis (n = 24) or dermatomyositis (n = 41) had pleural effusions clinically or at autopsy, although histological evidence of fibrinous pleuritis was seen occasionally [103]. Two patients with massive pleural effusions have been described, both presenting with marked pyrexia and a good response to corticosteroid therapy (tables 1, 2) [106]. …”

Section: Polymyositis/dermatomyositismentioning

confidence: 99%

Pleural Involvement in Systemic Autoimmune Disorders

2008

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Systemic autoimmune diseases, a heterogeneous group of immunologically mediated inflammatory disorders including multiorgan involvement, can affect the pleura with various frequencies, either as a single presenting feature or as part of multisystem involvement. Rheumatoid arthritis and systemic lupus erythematosus represent the most common immunological diseases that affect the pleural cavity; however, there is considerable variation regarding the reported prevalence, natural history and prognosis of pleural involvement in both conditions. The definition of pleural disease in the remaining systemic autoimmune disorders is unquestionably imprecise and assumptive, since it is risky to support premises based on single case reports or retrospective data from very small series. In this article, we will review the manifestations of pleural disease caused by rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis/dermatomyositis, mixed connective tissue disease, ankylosing spondylitis, Sjögren’s syndrome and Wegener’s granulomatosis.

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“…These radiological findings resolved under systemic corticosteroid therapy, suggesting that the pleural and pericardial effusions as well as the interstitial pneumonia originated from an immunological process, although we were unable to biochemically and cytologically assess the effusions. Previous reports have described unusual pleural and pericardial effusions associated with antisynthetase syndrome (12)(13)(14)(15). Interstitial pneumonia with autoimmune features was diagnosed in our patient based on the serological and radiological findings (16).…”

Section: Discussionmentioning

confidence: 58%

Anti-Jo-1 Antibody-positive Interstitial Pneumonia in an Elderly Patient with Congenital Rubella Syndrome

et al. 2019

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A 71-year-old woman with congenital rubella syndrome (CRS) presented with prolonged cough. No physical findings suggested the presence of any connective tissue diseases. Chest computed tomography showed ground-glass opacities and consolidations in the bilateral lower lobes. She had elevated serum Krebs von den Lungen-6, hypoxemia and positive serum anti-Jo-1 antibody. Bronchoalveolar lavage fluid revealed lymphocytosis with a decreased CD4/CD8 ratio. A transbronchial lung biopsy specimen revealed organizing pneumonia. Based on a diagnosis of interstitial pneumonia with autoimmune features (IPAF), systemic corticosteroids were administered, and a good outcome was obtained. A possible relationship between CRS and IPAF is herein discussed.

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Two Patients with Polymyositis or Dermatomyositis Complicated with Massive Pleural Effusion.

Cited by 18 publications

References 7 publications

Idiopathic inflammatory myopathies and the lung

Idiopathic inflammatory myopathies and the lung

Pleural Involvement in Systemic Autoimmune Disorders

Anti-Jo-1 Antibody-positive Interstitial Pneumonia in an Elderly Patient with Congenital Rubella Syndrome

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