Clinicial Significance of Spontaneous Pneumomediastinum in Dermatomyositis/Polymyositis.
10.4078/jkra.2010.17.2.143
- Author:
Jin Ju KIM
1
;
Dam KIM
;
Eun Kyoung KIM
;
Il Woong SOHN
;
Kyong Hee JUNG
;
Chan Bum CHOI
;
Yoon Kyoung SUNG
;
Jae Bum JUN
;
Wan sik UHM
;
Tae Hwan KIM
;
Sang Cheol BAE
;
Dae Hyun YOO
Author Information
1. Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea. dhyoo@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Pneumomediastinum;
Dermatomyositis/polymyositis;
Interstitial lung disease;
Prognosis
- MeSH:
Adrenal Cortex Hormones;
Cause of Death;
Dermatomyositis;
Follow-Up Studies;
Humans;
Immunosuppressive Agents;
Inhalation;
Lung;
Lung Diseases, Interstitial;
Mediastinal Emphysema;
Medical Records;
Myositis;
Polymyositis;
Prevalence;
Prognosis;
Retrospective Studies;
Rheumatic Diseases
- From:The Journal of the Korean Rheumatism Association
2010;17(2):143-152
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Pneumomediastinum (PnM), a rare complication of dermatomyositis and polymyositis (DM/PM), is sporadic and has an unclear pathogenesis. PnM is almost always associated with interstitial lung disease (ILD), and is a poor prognostic factor in inflammatory myositis patients. We studied the prevalence of PnM in Korean DM/PM and its clinical significance. METHODS: We retrospectively studied the medical records of 161 patients diagnosed with DM/PM meeting Bohan-Peter's criteria at Hanyang University Hospital for Rheumatic Diseases from 1995 to 2010. We collected following findings; demographic data, diagnosis, lung involvement, cause of death, and duration from diagnosis to death. RESULTS: One hundred nineteen patients (73.9%) were DM and 42 patients (26.1%) were PM. Eighty three patients (51.6%) developed ILD at diagnosis or during follow up. Eighteen patients (11.2%) died because of ILD aggravation, infection, or malignancy. The mean duration from diagnosis to death was 11.5 months, with 10 patients (6.2%) dying from from ILD aggravation but none with spontaneous PnM. 6 patients (3.7%) presented with PnM, and it was associated with ILD worsening in all cases. PnM resolved with O2 inhalation, corticosteroids, and/or immunosuppressive agents after 11 weeks (mean) of therapy. CONCLUSION: PnM is rare but associates with DM and aggravation of ILD. PnM does not usually cause fatalities and can be cured by appropriate therapy.
