Elevated lactate dehydrogenase and co-infection: predictors of rapidly progressive interstitial lung disease and fatal outcomes in anti-MDA5-positive dermatomyositis
Authors' conclusion
Respiratory symptoms, co-infection, and elevated LDH (≥ 324.5 IU/L) are independent risk factors for RP-ILD or death in anti-MDA5+ DM. For newly hospitalised patients, detailed symptom assessment, prompt infection screening (especially with winter/spring onset) and close LDH monitoring are crucial for prognosis evaluation and guiding clinical management.
Study context
- Population
- Anti-MDA5+ DM patients during their first hospitalisationanti-MDA5+ DM patients analysed during their first hospitalisation
- Participants
- 113 patients
- Outcome
- Prognosis, patients presenting primarily with respiratory symptoms vs skin/muscle symptoms
Main finding
As reported in the abstract
- Significantly poorer prognosis with respiratory symptoms than with skin/muscle symptoms
- p<0.05
Observational data: associations, not effects.
Further findings
Co-infection rates by season of onset
- Onset in winter/spring associated with higher co-infection rates
- p<0.05
RP-ILD or death in co-infected patients
- Co-infected patients had higher rates of RP-ILD or death
- p<0.05
Serum lactate dehydrogenase (LDH) levels in patients with RP-ILD or death
- Serum LDH levels significantly higher in patients with RP-ILD or death
- p<0.05
Original publication
Elevated lactate dehydrogenase and co-infection: predictors of rapidly progressive interstitial lung disease and fatal outcomes in anti-MDA5-positive dermatomyositis. Clin Exp Rheumatol. Published 30 November 2025. doi:10.
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