Fatal haemophagocytic syndrome in the course of dermatomyositis with anti-Mi2 antibodies.
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OBJECTIVE: To determine the serum levels of KL-6, a mucin-like high-molecular-weight glycoprotein, in polymyositis/dermatomyositis (PM/DM) patients. METHODS: Serum samples from 42 adult PM/DM patients and 38 healthy control subjects were examined using specific enzyme-linked immunosorbent assay (ELISA) systems. RESULTS: The serum levels of KL-6 in the PM/DM patients were significantly higher than those of the healthy controls. The elevated serum KL-6 levels correlated with the presence of interstitial lung disease (ILD) and decreased percentage diffusing capacity of carbon monoxide (%DLco) in the PM/DM patients. The serum KL-6 levels inversely correlated with %DLco and percentage vital capacity. Additionally, the serum KL-6 levels were elevated in five of the seven DM patients with malignant neoplasia. CONCLUSIONS: These results suggest that the serum KL-6 level might be a useful serum marker for ILD and internal malignancy in PM/DM.
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Recent developments in the identification of prognostic features, measures of disease activity, and responses to therapy in the childhood rheumatic diseases are summarized. Progress in understanding the immunopathogenesis of neonatal lupus erythematosus phenomenon and Kawasaki disease is reviewed.