Background: Pulmonary complications cause significant morbidity and mortality in patients with idiopathic inflammatory myopathies (IIMs).
Objectives: To describe the frequency and spectrum of pulmonary complications in patients with IIMs in South Africa (SA).
Methods: A retrospective records review of adult patients with IIMs or clinically amyopathic dermatomyositis (CADM) presenting with respiratory complaints at a tertiary care facility in SA was performed. Clinical features, results of laboratory and pulmonary function tests (PFTs), radiological findings and treatment were recorded.
Results: Pulmonary complications were documented in 66 patients. Most patients (n=41; 62.1%) had dermatomyositis, 14 (21.2%) had polymyositis, and 3 (4.5%) had CADM. There were 8 patients with overlap syndromes. Dyspnoea and a dry cough were the most common presenting symptoms, in 52 (78.8%) and 36 (54.5%) patients, respectively. Bibasal crackles were noted in 38 patients (57.6%). Interstitial lung disease (ILD), followed by infection and pulmonary hypertension (PH), were documented in 46 (69.7%), 16 (24.2%) and 9 (13.6%) patients, respectively. Nine patients had microbiologically confirmed pulmonary tuberculosis. Patients who were anti-Jo1 antibody positive (n=16) had higher levels of acute inflammatory markers and muscle enzymes compared with the rest of the patients (p<0.0001). Dyspnoea and bibasal crackles were associated with significantly lower baseline and 12-month lung function parameters. Nonspecific interstitial pneumonia was the most common radiological pattern of ILD, present in 25 (62.5%) of the patients with ILD.
Conclusion: ILD was the most prevalent complication in this study of SA patients with IIMs. Pulmonary infections and PH were also significant contributors to morbidity. The presence of dyspnoea and crackles was predictive of lower baseline PFTs in this population.
Study Synopsis: Pulmonary complications, including interstitial lung disease (ILD) and infections, are significant contributors to morbidity and mortality in patients with idiopathic inflammatory myopathies (IIMs). There is very little research currently available to describe the spectrum of pulmonary manifestations in these patients in an African setting, a lack that this study aimed to address. ILD was the most common pulmonary complication in patients with IIMs in this cohort. Signs and symptoms of ILD may be present before symptoms of myositis, and dyspnoea and a dry cough were shown to be predictive of reduced lung volumes. Patients with IIMs on immunosuppressive therapy in our setting are at high risk of infection, particularly tuberculosis.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606638 | PMC |
http://dx.doi.org/10.7196/AJTCCM.2024.v30i3.1663 | DOI Listing |
Neoplasia
December 2024
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
Leptomeningeal metastasis (LM) is a challenging complication of non-small cell lung cancer (NSCLC). Cerebrospinal fluid (CSF) cell-free DNA (cfDNA) analysis using next-generation sequencing (NGS) offers insights into resistance mechanisms and potential treatment strategies. We conducted a study from February 2022 to April 2023 involving patients from five hospitals in Taiwan who had recurrent or advanced NSCLC with LM.
View Article and Find Full Text PDFHinyokika Kiyo
November 2024
The Department of Urology, Hiroshima Prefectural Hospital.
A 26-year-old male presented to a hospital with complaints of hemoptysis and right scrotal swelling. Computed tomography (CT) revealed right testicular swelling, multiple lung metastases, and small intestinal wall thickening. The patient's β-human chorionic gonadotropin, alpha-fetoprotein, lactate dehydrogenase, and hemoglobin levels were 103.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
Background: This study aimed to develop predictive models with robust generalization capabilities for assessing the risk of pulmonary embolism in patients with tuberculosis using machine learning algorithms.
Methods: Data were collected from two centers and categorized into development and validation cohorts. Using the development cohort, candidate variables were selected via the Recursive Feature Elimination (RFE) method.
Cardiol Young
December 2024
Pediatric Cardiology Unit, University of Padua, Padova, Italy.
Almost 20% of children with simple or complex types of CHD have a duct-dependent circulation The systemic-to-pulmonary shunt can be performed surgically, e.g., Blalock-Taussing shunt or with a patent duct arteriosus stenting.
View Article and Find Full Text PDFInjury
December 2024
Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia; Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Melbourne, Victoria, Australia.
Unlabelled: Chest trauma is a common presentation to major trauma centres. Risk assessment tools have proven useful to support decision making in this group and the STUMBL (STUdy of the Management of BLunt chest wall trauma) score is one such measure that has been increasingly utilised. The aim of this study was to retrospectively validate the STUMBL score in an Australian population of patients admitted following chest trauma.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!