Do you screen for interstitial lung disease in patients with newly diagnosed polymyositis or dermatomyositis in the absence of respiratory symptoms?
I do screen all newly diagnosed IIM patients with PFTs and chest CT. This has a double purpose:
- establishing a baseline of lung function and,
- screening for lung cancer.
While the patient might not have lung symptoms on presentation, respiratory involvement can manifest later on the course of the d...
This is a very important clinical question, but requires a bit more nuance in order to answer:
We know that certain subtypes of dermatomyositis (DM) or polymyositis (PM) will be associated with higher or lower relative risks of interstitial lung disease (ILD). Moreover, certain subtypes are also mor...
I would say that we should always look for the presence of underlying ILD in patients with autoimmune inflammatory myopathies (AIM). In our center, we have seen a mini-epidemic of MDA-5 dermatomyositis, usually amyopathic with normal serum CKs but with skin necrosis, dysphagia, and aggressive and ra...
Let me deal with polymyositis (PM) first. My bias is that clinically pure PM is a rare disease, and most cases of PM occur in the setting of other SARDs or overlap syndromes. For example, one of the risk factors for ILD in PM is reported to be “rheumatoid arthritis,” which in mind suggests that it w...
Yes, for high-risk patients - Patient with anti-Synthetase syndrome or + Anti-Synthetase antibody; Or + anti-MDA5 or Overlap syndrome with systemic sclerosis or + Overlap antibodies - Anti-RNP, Ro52, PM-Scl, Ku.