Clinical and Pathological Findings of Interstitial Lung Disease Patients with Anti-Aminoacyl-tRNA Synthetase Autoantibodies
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概要
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Objective The aim of this study was to investigate the clinicopathological characteristics of interstitial lung disease (ILD) patients with anti-aminoacyl-tRNA synthetase (anti-ARS) autoantibodies. Patients and Methods We examined 14 ILD patients with anti-ARS autoantibodies between 2004 and 2007 and retrospectively investigated their clinical, radiographic, and pathological findings. Results Anti-Jo-1 antibodies were the most common (10 of 14), followed by anti-OJ, anti-KS, and anti-EJ (1 each for 3 patients); 1 patient with polymyositis had both anti-Jo-1 and anti-PL-12 antibodies. Ten patients had a chronic clinical course, whereas 4 presented with subacute deterioration. Of 8 patients with myositis, 1 (12.5%) had myositis-preceding ILD, 3 (37.5%) had ILD-preceding myositis, and 4 (50%) had simultaneous onset. Chest high-resolution computed tomography frequently showed lung-base predominant ground glass opacities (GGO) with volume loss. The results of surgical lung biopsies indicated that 4 patients had nonspecific interstitial pneumonia (NSIP) and/or organizing pneumonia (OP) patterns. All but 1 received corticosteroid therapy, and 6 patients were also given cyclosporin. The mean duration of follow-up was 22 months (range, 5-47 months). ILD improved in 9 patients and stabilized in 3; however, in 1 patient, it initially improved during 6 months, then progressively worsened despite treatment, and finally resulted in death. Conclusion These results indicate that ILD patients with anti-ARS antibodies usually have a chronic clinical course, lung-base predominant GGO with volume loss, NSIP and/or OP patterns, and a good response to corticosteroid treatment; however, some have a rapidly worsening course and recurrence, despite therapy.
著者
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Fujimoto Manabu
Department Of Cardiology Kanazawa National Hospital
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Kuwana Masataka
Division Of Rheumatology Department Of Internal Medicine Keio University School Of Medicine
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Fukuda Yuh
Department Of Analytic Human Pathology Nippon Medical School
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HIGASHIMOTO Ikkou
Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital
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Kaji Kenzo
Department Of Dermatology Graduate School Of Medicine Kanazawa University
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Yamamoto Masuki
Division Of Respiratory Medicine Respiratory And Stress Care Center Kagoshima University Hospital
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Koreeda Yoshimizu
Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital
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Takahashi Mikiko
Department of Analytic Human Pathology, Nippon Medical School
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