抗黑色素瘤分化相关基因5抗体阳性皮肌炎的临床和胸部CT表现

目的:探讨抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎患者的临床表现及胸部损害的CT表现。方法:回顾性分析2017年2月至2019年10月在河南科技大学第一附属医院确诊的15例抗MDA5抗体阳性皮肌炎患者的临床表现、实验室检查及胸部CT表现。实验室检查指标主要包括抗MDA5抗体、抗Ro-52抗体、肌酸激酶等。胸部...

Clinical and chest CT manifestations of anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis

Objective To explore the clinical and chest CT features of anti-melanoma differentiation-associated gene 5(MDA5)antibody positive dermatomyositis.Methods Fifteen patients confirmed with anti-MDA5 antibody positive dermatomyositis in the First Affiliated Hospital of Henan University of Science and Technology from February 2017 to October 2019 were included in this study.The clinical data,laboratory results and CT images of the patients were retrospectively reviewed.The laboratory indicators included anti-MDA5 antibody,anti-Ro-52 antibody and creatine kinase.As for the CT imaging features,the pulmonary manifestations(interlobular septal thickening,intralobular interstitial thickening,peribronchovascular interstitial thickening,ground glass opacity,subpleural arc,consolidation,lung parenchymal zone,subpleural interstitial thickening,tractive bronchiectasis)and extrapulmonary manifestations(axillary lymph node enlargement,mediastinal emphysema,pleural effusion)were reviewed and recorded.Results Twelve cases had rash and 8 cases had oral and skin ulcers.Laboratory tests showed 15 cases with anti-MDA5 antibody positive,12 cases with anti-Ro-52 antibody positive,and 2 cases with creatine kinase increased.CT showed that 15 patients had pulmonary interstitial changes,of which 10 cases were mainly interstitial lesions,4 cases had pulmonary interstitial changes and pulmonary parenchyma lesions,1 case was mainly pulmonary parenchyma lesions.Eleven cases had ground glass opacity,10 cases had lobular septal thickening,7 cases had bronchial vascular bundle abnormalities,9 cases had subpleural arc,5 cases had lobular interstitial thickening.Three cases had axillary lymph node enlargement,1 case had mediastinal emphysema,3 cases had pleural effusion;No case of pulmonary fibrosis.Conclusions Most patients with anti-MDA5 antibody positive dermatomysitis have rash or oral cavity and skin ulcer.CT features are mainly presented as interstitial lung disease.Ground glass opacity and lobular septal thickening are common.Bronchial vascular bundle abnormalities,subpleural arc and lobular interstitial thickening can coexist in this disease.