Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.

<h4>Background</h4>Idiopathic inflammatory myositis (IIM) frequently coexists with interstitial lung disease (ILD), significantly impacting morbidity and mortality. Spontaneous pneumomediastinum, a complication of myositis-associated ILD, remains understudied regarding its clinical impli...

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Main Authors: Junghee Jung, Min Jee Kim, Bin Yoo, Chang-Keun Lee, Yong-Gil Kim, Seokchan Hong, Soo Min Ahn, Ho Cheol Kim
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0328043
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author Junghee Jung
Min Jee Kim
Bin Yoo
Chang-Keun Lee
Yong-Gil Kim
Seokchan Hong
Soo Min Ahn
Ho Cheol Kim
author_facet Junghee Jung
Min Jee Kim
Bin Yoo
Chang-Keun Lee
Yong-Gil Kim
Seokchan Hong
Soo Min Ahn
Ho Cheol Kim
author_sort Junghee Jung
collection DOAJ
description <h4>Background</h4>Idiopathic inflammatory myositis (IIM) frequently coexists with interstitial lung disease (ILD), significantly impacting morbidity and mortality. Spontaneous pneumomediastinum, a complication of myositis-associated ILD, remains understudied regarding its clinical implications.<h4>Method</h4>We retrospectively reviewed patients diagnosed with myositis-associated ILD at Asan Medical Center, Seoul, South Korea, from April 2012 to September 2023. Patients were categorized into two groups based on the presence or absence of spontaneous pneumomediastinum during the follow-up period.<h4>Results</h4>Among the 70 patients included in the study, the median age was 55.9 ± 12.2 years, with 62.9% being female. Pneumomediastinum developed in 12 (17.1%) patients. Clinical characteristics did not significantly differ between the pneumomediastinum and non-pneumomediastinum groups, except for the subtype of IIM. Notably, pneumomediastinum was observed in 11 (91.7%) patients with dermatomyositis and 1 (8.3%) with anti-synthetase syndrome (ASS), but none with polymyositis. Multivariate analysis revealed pneumomediastinum as a significant risk factor for mortality (hazard ratio: 2.829, 95% confidence interval: 1.100-7.270, p = 0.031) after adjusting for other variables. Patients with pneumomediastinum exhibited worse survival compared with patients without pneumomediastinum (median survival time: 77.7 ± 11.7 vs. 13.6 ± 3.7 months, p = 0.013).<h4>Conclusion</h4>Spontaneous pneumomediastinum is an independent risk factor for mortality in patients with myositis-associated ILD.
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spelling doaj-art-81697fa00caf4dd9b603ccaeea76259f2025-08-20T03:13:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032804310.1371/journal.pone.0328043Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.Junghee JungMin Jee KimBin YooChang-Keun LeeYong-Gil KimSeokchan HongSoo Min AhnHo Cheol Kim<h4>Background</h4>Idiopathic inflammatory myositis (IIM) frequently coexists with interstitial lung disease (ILD), significantly impacting morbidity and mortality. Spontaneous pneumomediastinum, a complication of myositis-associated ILD, remains understudied regarding its clinical implications.<h4>Method</h4>We retrospectively reviewed patients diagnosed with myositis-associated ILD at Asan Medical Center, Seoul, South Korea, from April 2012 to September 2023. Patients were categorized into two groups based on the presence or absence of spontaneous pneumomediastinum during the follow-up period.<h4>Results</h4>Among the 70 patients included in the study, the median age was 55.9 ± 12.2 years, with 62.9% being female. Pneumomediastinum developed in 12 (17.1%) patients. Clinical characteristics did not significantly differ between the pneumomediastinum and non-pneumomediastinum groups, except for the subtype of IIM. Notably, pneumomediastinum was observed in 11 (91.7%) patients with dermatomyositis and 1 (8.3%) with anti-synthetase syndrome (ASS), but none with polymyositis. Multivariate analysis revealed pneumomediastinum as a significant risk factor for mortality (hazard ratio: 2.829, 95% confidence interval: 1.100-7.270, p = 0.031) after adjusting for other variables. Patients with pneumomediastinum exhibited worse survival compared with patients without pneumomediastinum (median survival time: 77.7 ± 11.7 vs. 13.6 ± 3.7 months, p = 0.013).<h4>Conclusion</h4>Spontaneous pneumomediastinum is an independent risk factor for mortality in patients with myositis-associated ILD.https://doi.org/10.1371/journal.pone.0328043
spellingShingle Junghee Jung
Min Jee Kim
Bin Yoo
Chang-Keun Lee
Yong-Gil Kim
Seokchan Hong
Soo Min Ahn
Ho Cheol Kim
Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
PLoS ONE
title Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
title_full Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
title_fullStr Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
title_full_unstemmed Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
title_short Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease.
title_sort clinical impact of pneumomediastinum in patients with myositis associated interstitial lung disease
url https://doi.org/10.1371/journal.pone.0328043
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