Prognosis of spontaneous pneumomediastinum occurring in dermatomyositis or polymyositis patients with interstitial lung disease according to antimelanoma differentiation-associated gene 5 antibody status: a retrospective cohort study
Summary of the Study
- This study aimed to investigate the prognosis of spontaneous pneumomediastinum (SPM) occurring in dermatomyositis or polymyositis (DM/PM) patients with interstitial lung disease (ILD) according to antimelanoma differentiation-associated gene 5 (MDA5) antibody status.
- A retrospective cohort study was conducted on DM/PM patients with ILD who were admitted to the Department of Rheumatology at the First Affiliated Hospital of China Medical University between January 2011 and December 2018.
- The results showed that the MDA5 antibody-positive group had a higher incidence of SPM than the MDA5 antibody-negative group (P < 0.001).
- The MDA5 antibody-positive group had a higher mortality rate than the MDA5 antibody-negative group (P = 0.001).
- The MDA5 antibody-positive group had a higher rate of recurrence of SPM than the MDA5 antibody-negative group (P = 0.001).
- The MDA5 antibody-positive group had a higher rate of complications than the MDA5 antibody-negative group (P = 0.001).
- The results of this study suggest that MDA5 antibody status is an important predictor of the prognosis of SPM in DM/PM patients with ILD.
Detailed Overview of the Study
Spontaneous pneumomediastinum (SPM) is a rare clinical condition that is characterized by the presence of air in the mediastinum. It is usually caused by a rupture of the alveoli or bronchi, and is often associated with underlying diseases such as asthma, cystic fibrosis, and interstitial lung disease (ILD). The prognosis of SPM is usually poor, and the mortality rate is high. The aim of this study was to investigate the prognosis of SPM occurring in dermatomyositis or polymyositis (DM/PM) patients with ILD according to antimelanoma differentiation-associated gene 5 (MDA5) antibody status.
A retrospective cohort study was conducted on DM/PM patients with ILD who were admitted to the Department of Rheumatology at the First Affiliated Hospital of China Medical University between January 2011 and December 2018. The patients were divided into two groups according to their MDA5 antibody status: the MDA5 antibody-positive group and the MDA5 antibody-negative group. The primary outcome was the incidence of SPM, and the secondary outcomes were mortality rate, recurrence rate, and complication rate.
The results showed that the MDA5 antibody-positive group had a higher incidence of SPM than the MDA5 antibody-negative group (P < 0.001). The MDA5 antibody-positive group had a higher mortality rate than the MDA5 antibody-negative group (P = 0.001). The MDA5 antibody-positive group had a higher rate of recurrence of SPM than the MDA5 antibody-negative group (P = 0.001). The MDA5 antibody-positive group had a higher rate of complications than the MDA5 antibody-negative group (P = 0.001).
The results of this study suggest that MDA5 antibody status is an important predictor of the prognosis of SPM in DM/PM patients with ILD. Further studies are needed to confirm these findings and to explore the underlying mechanisms.
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