Abstract | OBJECTIVE: PATIENTS AND METHODS: Fifty consecutive patients with PM (n = 17) or DM (n = 33) and active IP, 6 of whom died of respiratory failure, were enrolled in this study. Serum KL-6 and SP-D levels were measured every 2-4 weeks. Medical records were reviewed retrospectively. Univariate analyses and multivariate analyses with a logistic regression model were conducted. RESULTS: Serum KL-6 and SP-D levels were elevated in patients with active IP. At the time of diagnosis of active IP, the serum KL-6 level was within the normal range in 28 % of patients and the SP-D level was within the normal range in 46 % of patients. Serum KL-6 level increased up to 3 months after starting treatment and then decreased gradually to baseline, whereas SP-D level peaked within the first 4 weeks after treatment and decreased rapidly to normal levels. Patients with poor prognosis showed increases in KL-6 and SP-D levels during the first 4 weeks after treatment, which was confirmed by uni- and multivariate analyses. Comparing the marker levels at 2-4 weeks after treatment with those at 0 weeks, an increase in the ratio over 1.70 for KL-6 and over 1.75 for SP-D, and an increase in KL-6 over 850 U/ml during the first 4 weeks after treatment, were poor prognostic factors. CONCLUSIONS: Increases in serum KL-6 and SP-D levels during the first 4 weeks after starting therapy, but not their levels at any one time point, predict poor prognosis in patients with PM/DM. When marked increases of KL-6 and SP-D levels during the first 4 weeks are found or are predicted by serial measurement of the markers, patients have risks of poor prognosis and additional therapy should be considered.
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Authors | Satoko Arai, Kazuhiro Kurasawa, Reika Maezawa, Takayoshi Owada, Harutsugu Okada, Takeshi Fukuda |
Journal | Modern rheumatology
(Mod Rheumatol)
Vol. 23
Issue 5
Pg. 872-83
(Sep 2013)
ISSN: 1439-7609 [Electronic] England |
PMID | 22983659
(Publication Type: Journal Article)
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Chemical References |
- MUC1 protein, human
- Mucin-1
- Pulmonary Surfactant-Associated Protein D
|
Topics |
- Adult
- Aged
- Dermatomyositis
(blood, complications, drug therapy)
- Female
- Humans
- Lung Diseases, Interstitial
(blood, complications, drug therapy)
- Male
- Middle Aged
- Mucin-1
(blood)
- Prognosis
- Pulmonary Surfactant-Associated Protein D
(blood)
- Retrospective Studies
- Treatment Outcome
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