Slowly progressive interstitial lung disease preceding typical dermatomyositis symptoms in anti-melanoma differentiation-associated gene 5 antibody-positive clinically amyopathic dermatomyositis

• Main Authors: Taisuke Isono, Hiromi Nakajima, Kenji Takano, Yoichi Kobayashi, Yoshinori Kawabata, Yoshihiko Shimizu, Noboru Takayanagi
• Format: Article
• Language: English
• Published: Elsevier 2021-01-01
• Series: Respiratory Medicine Case Reports
• Subjects: Anti-melanoma differentiation-associated gene 5; Clinically amyopathic dermatomyositis; Interstitial lung disease; Slowly progressive; Surgical lung biopsy
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007121001532

A 73-year-old woman who visited our hospital complaining of dry cough for three months was refractory to antimicrobial therapy. Chest computed tomography revealed subpleural consolidation. Specimens obtained from surgical lung biopsy revealed subpleural perilobular airspace organization and fibrosis. After the biopsy, mechanic's hand and Gottron's papules appeared, and anti-melanoma differentiation-associated gene 5 (MDA5) antibody was found to be positive. Subsequently, anti-MDA5 antibody measured in cryopreserved serum from her first admission proved to be positive. It is difficult to suspect the presence of anti-MDA-5 antibody in patients with interstitial lung disease without typical dermatomyositis symptoms or slow disease progression.