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Erschienen in: Clinical Rheumatology 11/2007

01.11.2007 | Original Article

Outcome of patients having dermatomyositis admitted to the intensive care unit

verfasst von: Yaniv Sherer, Daniel Shepshelovich, Tamara Shalev, Yael Haviv, Eran Segal, Michael Ehrenfeld, Yair Levy, Rachel Pauzner, Yehuda Shoenfeld, Pnina Langevitz

Erschienen in: Clinical Rheumatology | Ausgabe 11/2007

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Abstract

Patients having systemic rheumatic diseases constitute a small percentage of admissions to the medical intensive care units (ICUs). Dermatomyositis (DM) is one of the rheumatic diseases that have secondary complications that may lead to a critical illness requiring hospitalization in the ICU. Herein, we present the features, clinical course, and outcome of critically ill patients having DM who were admitted to the ICU. The medical records of six DM patients admitted to the ICU in a large tertiary hospital in a 12-year period were reviewed. The mean age of patients at time of admission to the ICU was 38 (range 16–37). Mean disease duration from diagnosis to admission to the ICU was 1.6 years (range 1 month–8 years), while the main reason for admission to the ICU was acute respiratory failure. Two of six patients died during the hospitalization. The main causes of death were respiratory complications and sepsis. The outcome of DM patients admitted to the ICU was generally not different from the outcome of other patients hospitalized in the ICU. The main reason for hospitalization was acute respiratory failure. As there are many reasons for respiratory failure in DM, an early diagnosis and aggressive appropriate treatment may help to further reduce the mortality in these patients.
Literatur
1.
Zurück zum Zitat Janssen NM, Karnad DR, Guntupalli KK (2002) Rheumatologic diseases in the intensive care unit: epidemiology, clinical approach, management and outcome. Crit Care Clin 18:720–748CrossRef Janssen NM, Karnad DR, Guntupalli KK (2002) Rheumatologic diseases in the intensive care unit: epidemiology, clinical approach, management and outcome. Crit Care Clin 18:720–748CrossRef
2.
Zurück zum Zitat Kollef MH, Enzenauer RJ (1992) Predicting outcome from intensive care for patients with rheumatologic diseases. J Rheumatol 19:1260–1262PubMed Kollef MH, Enzenauer RJ (1992) Predicting outcome from intensive care for patients with rheumatologic diseases. J Rheumatol 19:1260–1262PubMed
3.
Zurück zum Zitat Godwau B, Mortier E, Roy PM et al (1997) Short and long-term outcomes for patients with rheumatic diseases admitted to the intensive care unit: a prognostic study of 181 patients. J Rheumatol 24:1317–1323 Godwau B, Mortier E, Roy PM et al (1997) Short and long-term outcomes for patients with rheumatic diseases admitted to the intensive care unit: a prognostic study of 181 patients. J Rheumatol 24:1317–1323
4.
Zurück zum Zitat Shalev T, Haviv Y, Segal E, Ehrenfeld M, Pauzner R, Levy Y, Langevitz P, Shoenfeld Y (2006) Outcome of patients with scleroderma admitted to intensive care unit. A report of nine cases. Clin Exp Rheumatol 24:380–386PubMed Shalev T, Haviv Y, Segal E, Ehrenfeld M, Pauzner R, Levy Y, Langevitz P, Shoenfeld Y (2006) Outcome of patients with scleroderma admitted to intensive care unit. A report of nine cases. Clin Exp Rheumatol 24:380–386PubMed
5.
Zurück zum Zitat Dalakas MC (1991) Polymyositis, DM, and inclusion-body myositis. N Engl J Med 325:1487–1498PubMedCrossRef Dalakas MC (1991) Polymyositis, DM, and inclusion-body myositis. N Engl J Med 325:1487–1498PubMedCrossRef
6.
Zurück zum Zitat Tymms KE, Webb J (1985) Dermatopolymyositis and other connective tissue diseases. A review of 105 cases. J Rheumatol 12:1140–1148PubMed Tymms KE, Webb J (1985) Dermatopolymyositis and other connective tissue diseases. A review of 105 cases. J Rheumatol 12:1140–1148PubMed
7.
Zurück zum Zitat Schwartz M (1998) The lung in polymyositis. Clin Chest Med 19:701–712CrossRef Schwartz M (1998) The lung in polymyositis. Clin Chest Med 19:701–712CrossRef
8.
Zurück zum Zitat Douglas WW, Tazelaar HD, Hartman TE et al (2001) Polymyositis-DM associated interstitial lung disease. Am J Respir Crit Care Med 164:1182–1185PubMed Douglas WW, Tazelaar HD, Hartman TE et al (2001) Polymyositis-DM associated interstitial lung disease. Am J Respir Crit Care Med 164:1182–1185PubMed
9.
10.
Zurück zum Zitat Astudillo LM, Arriero M, Sailler L, Dingremont CF, Arlet PM (2001) Hypercapnic coma due to diaphragmatic involvement in a patient with DM. Clin Exp Rheumatol 19(4):456–458, Jul–AugPubMed Astudillo LM, Arriero M, Sailler L, Dingremont CF, Arlet PM (2001) Hypercapnic coma due to diaphragmatic involvement in a patient with DM. Clin Exp Rheumatol 19(4):456–458, Jul–AugPubMed
11.
Zurück zum Zitat Kuwana M (2004) Collagen diseases with pulmonary involvement. Nihon Rinsho Men’eki Gakkai Kaishi 27(3):118–126, JunPubMed Kuwana M (2004) Collagen diseases with pulmonary involvement. Nihon Rinsho Men’eki Gakkai Kaishi 27(3):118–126, JunPubMed
12.
Zurück zum Zitat Sakamoto N, Mukae H, Fuji T, Yoshioka S, Kakugawa T, Yamaguchi H, Hayashi T, Kohno S (2004) Nonspecific interstitial pneumonia with poor prognosis associated with amyopathic DM. Intern Med 43(9):838–842, SepPubMedCrossRef Sakamoto N, Mukae H, Fuji T, Yoshioka S, Kakugawa T, Yamaguchi H, Hayashi T, Kohno S (2004) Nonspecific interstitial pneumonia with poor prognosis associated with amyopathic DM. Intern Med 43(9):838–842, SepPubMedCrossRef
13.
Zurück zum Zitat Cherin P, Herson S (1994) Indications for intravenous gammaglobulin therapy in inflammatory myopathies. J Neurol Neurosurg Psychiatry 57:50–54PubMed Cherin P, Herson S (1994) Indications for intravenous gammaglobulin therapy in inflammatory myopathies. J Neurol Neurosurg Psychiatry 57:50–54PubMed
14.
Zurück zum Zitat Dalakas MC et al (1993) A controlled trial of high dose intravenous immune globulin infusions as treatment for DM. N Eng J Med 329:1993–2000CrossRef Dalakas MC et al (1993) A controlled trial of high dose intravenous immune globulin infusions as treatment for DM. N Eng J Med 329:1993–2000CrossRef
15.
Zurück zum Zitat Dalakas MC (1994) How to diagnose and treat the inflammatory myopathies. Semin Neurol 14:137–145PubMedCrossRef Dalakas MC (1994) How to diagnose and treat the inflammatory myopathies. Semin Neurol 14:137–145PubMedCrossRef
16.
Zurück zum Zitat Joffe MM et al (1993) Drug therapy of the idiopathic myopathies: Predictors of response to prednisone, azathioprine and methotrexate and a comparison of their efficacy. Am J Med 94:379–387PubMedCrossRef Joffe MM et al (1993) Drug therapy of the idiopathic myopathies: Predictors of response to prednisone, azathioprine and methotrexate and a comparison of their efficacy. Am J Med 94:379–387PubMedCrossRef
17.
Zurück zum Zitat Haskard DO (1983) Successful treatment of DM complicated by ventilatory failure. Ann Rheum Dis 42(4):460–461, AugPubMedCrossRef Haskard DO (1983) Successful treatment of DM complicated by ventilatory failure. Ann Rheum Dis 42(4):460–461, AugPubMedCrossRef
18.
Zurück zum Zitat Shinohara T, Hidaka T, Matsuki Y, Ishizuka T, Takamizawa M, Kawakami M, Kikuma H, Suzuki K, Nakamura H (1997) Rapidly progressive lung disease associated with DM responding to intravenous cyclophosphamide pulse therapy. Intern Med 36(7):519–523, JulPubMed Shinohara T, Hidaka T, Matsuki Y, Ishizuka T, Takamizawa M, Kawakami M, Kikuma H, Suzuki K, Nakamura H (1997) Rapidly progressive lung disease associated with DM responding to intravenous cyclophosphamide pulse therapy. Intern Med 36(7):519–523, JulPubMed
19.
Zurück zum Zitat Selva-O’Callaghan A, Sanchez-Sitjes L, Munoz-Gall X, Mijares-Boeckh-Behrens T, Solans-Laque R, Angel Bosch-Gil J, Morell-Brotad F, Vilardell-Tarres M (2000) Respiratory failure due to muscle weakness in inflammatory myopathies: maintenance therapy with home mechanical ventilation. Rheumatology (Oxford) 39(8):914–916, AugCrossRef Selva-O’Callaghan A, Sanchez-Sitjes L, Munoz-Gall X, Mijares-Boeckh-Behrens T, Solans-Laque R, Angel Bosch-Gil J, Morell-Brotad F, Vilardell-Tarres M (2000) Respiratory failure due to muscle weakness in inflammatory myopathies: maintenance therapy with home mechanical ventilation. Rheumatology (Oxford) 39(8):914–916, AugCrossRef
Metadaten
Titel
Outcome of patients having dermatomyositis admitted to the intensive care unit
verfasst von
Yaniv Sherer
Daniel Shepshelovich
Tamara Shalev
Yael Haviv
Eran Segal
Michael Ehrenfeld
Yair Levy
Rachel Pauzner
Yehuda Shoenfeld
Pnina Langevitz
Publikationsdatum
01.11.2007
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 11/2007
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-007-0588-z

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