Anti-MDA5 antibody-positive rapidly progressive interstitial pneumonia without cutaneous manifestations

• Main Authors: Junichi Aoyama, Hiroki Hayashi, Chika Yajima, Hiroyuki Takoi, Toru Tanaka, Takeru Kashiwada, Nariaki Kokuho, Yasuhiro Terasaki, Ayumi Nishikawa, Takahisa Gono, Masataka Kuwana, Yoshinobu Saito, Shinji Abe, Masahiro Seike, Akihiko Gemma
• Format: Article
• Language: English
• Published: Elsevier 2019-01-01
• Series: Respiratory Medicine Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007118303836

A 47-year-old man was referred to our hospital with a 1-month history of fever and dyspnea after inhalation of insecticide in a confined space. We diagnosed rapidly progressive interstitial pneumonia. High-dose methylprednisolone, tacrolimus, and intermittent infusion of cyclophosphamide were administered. His condition rapidly deteriorated; therefore, extracorporeal membrane oxygenation therapy was performed. Unfortunately, he died 69 days after admission. Although typical skin findings suggestive of dermatomyositis were absent, anti-melanoma differentiation-associate gene (anti-MDA5) antibody was positive. Our findings suggest that in patients with hyperferritinemia and rapidly progressive interstitial lung disease (RP-ILD) demonstrating random ground glass shadows and peripheral consolidations by high-resolution computed tomography (HRCT) even if skin manifestations related to dermatomyositis are not complicated, we should assume anti-MDA5 antibody-positive interstitial pneumonia. Keywords: Anti-melanoma differentiation-associated gene 5 antibody, Rapidly progressive interstitial pneumonia, Clinical amyopathic dermatomyositis, Extracorporeal membrane oxygenation