Alveolitis may persist during treatment that sufficiently controls muscle inflammation in myositis

Eight patients with dermato- and polymyositis (DM/PM) and two further cases with scleroderma-myositis overlap syndrome were investigated. These patien ts showed signs of lung manifestation by noninvasive methods. Bronchoalveol ar lavage (BAL) was performed to detect alveolitis. Four of the eight DM/PM patients showed elevated neutrophil counts. All of these and one additiona l case had increased lymphocyte counts. Five of the DM/PM patients showed h igher total cell numbers than five healthy controls. One of the cases with scleroderma-myositis overlap syndrome also developed lymphocyte alveolitis. We conclude that signs of alveolitis are often present in patients with my ositis, even though the myositis was adequately controlled by corticosteroi d therapy and, in four cases, with corticosteroid plus azathioprine. The ne ed for further follow-up studies to determine the effectiveness of intensif ied corticosteroid/cytostatic treatment in these patients is emphasised.