| Infections in polymyositis and dermatomyositis: analysis of 192 cases. | |
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MedLine Citation:
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PMID: 20837496 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: To estimate the incidence, characteristics and predictors of infections in patients with PM and DM. METHODS: The medical records of 192 PM/DM patients followed up in a tertiary teaching medical centre from 1999 to 2008 were retrospectively reviewed. RESULTS: Seventy-six episodes of major infection, defined as infections requiring>1 week of treatment with anti-microbial agents, occurred in 53 (27.6%) patients, and 15 (7.8%) patients had two or more episodes. The incidence rate of major infections was 11.1 episodes per 100 patient-years in PM/DM patients. Aspiration pneumonia [n (%)=16 (21.1)] was the leading cause of major infections, followed by opportunistic infection [n (%)=14 (18.4)]. A variety of pathogens were isolated, mainly including Staphylococcus aureus, Klebsiella, Escherichia coli, Salmonella and Mycobacterium. Overall patient survival rates were 85.0% at 1 year, 78.0% at 5 years and 78.0% at 10 years. However, after one episode of major infection, survival rates decreased to 84.7% at 30 days and 68.3% at 1 year. Multivariate analysis indicated that independent predictors of major infection were age>45 years at PM/DM onset [odds ratio (OR) 5.26; 95% CI 2.01, 13.77; P=0.001], presence of arthritis/arthalgia (OR 2.59; 95% CI 1.12, 6.02; P=0.027), co-present interstitial lung disease (OR 7.24; 95% CI 2.67, 19.65; P<0.001), current use of AZA (OR 6.07; 95% CI 2.39, 15.42; P<0.001) or IVIG (OR 6.33; 95% CI 1.50, 26.77; P=0.012). CONCLUSIONS: This study underlines the high frequency of major infections in PM/DM, which is significantly detrimental to patient survival rates. Close follow-up of PM/DM patients with risk factors for developing major infections is mandatory. |
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Authors:
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I-Jung Chen; Wen-Pin Tsai; Yeong-Jian Jan Wu; Shue-Fen Luo; Huei-Huang Ho; Lieh-Bang Liou; Ji-Yih Chen; Chang-Fu Kuo; Hsiao-Chun Chang; Chung-Han Yang; Kuang-Hui Yu |
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Publication Detail:
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Type: Journal Article Date: 2010-09-13 |
Journal Detail:
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Title: Rheumatology (Oxford, England) Volume: 49 ISSN: 1462-0332 ISO Abbreviation: Rheumatology (Oxford) Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883501 Medline TA: Rheumatology (Oxford) Country: England |
Other Details:
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Languages: eng Pagination: 2429-37 Citation Subset: AIM; IM |
Affiliation:
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Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kuei-Shan (333), Tao-Yuan, Taiwan, Republic of China. gout@adm.cgmh.org.tw. |
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