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 sclerodermamyositis overlap syndrome were investigated. These patients showed signs of lung manifestation by noninvasive methods. Bronchoalveolar lavage (BAL) was performed to detect alveolitis. Four of the eight DM/PM patients showed elevated neutrophil counts. All of these and one additional case had increased lymphocyte counts. Five of the DM/PM patients showed higher 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 myositis, even though the myositis was adequately controlled by corticosteroid therapy and, in four cases, with corticosteroid plus azathioprine. The need for further follow-up studies to determine the effectiveness of intensified corticosteroid/cytostatic treatment in these patients is emphasised.