Yong Peng Ge1, Xiao Ming Shu1, Lin Rong He1, Guo Chun Wang1, Xin Lu2. 1. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China. 2. Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China. luxin_n@163.com.
Abstract
OBJECTIVES: To assess the prevalence and characteristics of infections in patients with idiopathic inflammatory myopathies (IIM) and analyse risk factors for infection using clinical presentation and biochemical findings of IIM. METHODS: Retrospective review of the medical records of patients with IIM followed up in a single medical centre from January 2008 to January 2018. RESULTS: Of the 779 patients with IIM, 215 (27.6%) suffered from infections. The prevalence of infection in dermatomyositis (DM) (29.8%) was more than polymyositis (PM) (18.5%). The lung was the most common infection site (66.5%). Multivariate analyses demonstrated that methylprednisolone pulse (MP) (OR=3.22; 95% CI=1.60 - 6.48; p=0.001), age of onset >50 years (OR=1.02; 95% CI=1.00 - 1.03; p=0.011), anti-melanoma differentiation-associated gene 5 (MDA5) antibody (OR=1.93; 95% CI=1.20 - 3.11; p=0.007), lymphocyte count <1200/mm3 (OR=2.85; 95% CI=1.89 - 4.30; p<0.001), and interstitial lung diseases (ILD) (OR=2.03; 95% CI=1.30 - 3.71; p=0.002) are independent risk factors for infection. Survival analysis demonstrated that the three-year survival rate in the infection group was lower than the no-infection group (75.3% vs. 94.7%, p < 0.001). CONCLUSIONS: Among hospitalised individuals with IIM, infection is frequent and the leading cause of mortality. The anti-MDA5 antibody, lymphopenia, ILD, old age, and treatment with MP are contributing factors in the development of infections in patients with IIM.
OBJECTIVES: To assess the prevalence and characteristics of infections in patients with idiopathic inflammatory myopathies (IIM) and analyse risk factors for infection using clinical presentation and biochemical findings of IIM. METHODS: Retrospective review of the medical records of patients with IIM followed up in a single medical centre from January 2008 to January 2018. RESULTS: Of the 779 patients with IIM, 215 (27.6%) suffered from infections. The prevalence of infection in dermatomyositis (DM) (29.8%) was more than polymyositis (PM) (18.5%). The lung was the most common infection site (66.5%). Multivariate analyses demonstrated that methylprednisolone pulse (MP) (OR=3.22; 95% CI=1.60 - 6.48; p=0.001), age of onset >50 years (OR=1.02; 95% CI=1.00 - 1.03; p=0.011), anti-melanoma differentiation-associated gene 5 (MDA5) antibody (OR=1.93; 95% CI=1.20 - 3.11; p=0.007), lymphocyte count <1200/mm3 (OR=2.85; 95% CI=1.89 - 4.30; p<0.001), and interstitial lung diseases (ILD) (OR=2.03; 95% CI=1.30 - 3.71; p=0.002) are independent risk factors for infection. Survival analysis demonstrated that the three-year survival rate in the infection group was lower than the no-infection group (75.3% vs. 94.7%, p < 0.001). CONCLUSIONS: Among hospitalised individuals with IIM, infection is frequent and the leading cause of mortality. The anti-MDA5 antibody, lymphopenia, ILD, old age, and treatment with MP are contributing factors in the development of infections in patients with IIM.
Authors: Rohit Aggarwal; Latika Gupta; Leonardo Santos Hoff; Naveen Ravichandran; Samuel Katsuyuki Shinjo; Jessica Day; Parikshit Sen; Jucier Gonçalves Junior; James B Lilleker; Mrudula Joshi; Vishwesh Agarwal; Sinan Kardes; Minchul Kim; Marcin Milchert; Ashima Makol; Tamer Gheita; Babur Salim; Tsvetelina Velikova; Abraham Edgar Gracia-Ramos; Ioannis Parodis; Albert Selva O'Callaghan; Elena Nikiphorou; Ai Lyn Tan; Tulika Chatterjee; Lorenzo Cavagna; Miguel A Saavedra; Nelly Ziade; Johannes Knitza; Masataka Kuwana; Arvind Nune; Oliver Distler; Döndü Üsküdar Cansu; Lisa Traboco; Suryo Angorro Kusumo Wibowo; Erick Adrian Zamora Tehozol; Jorge Rojas Serrano; Ignacio García-De La Torre; Chris Wincup; John D Pauling; Hector Chinoy; Vikas Agarwal Journal: Rheumatol Int Date: 2022-10-22 Impact factor: 3.580