Rapidly progressive interstitial lung disease due to anti-MDA-5 antibody-positive clinically amyopathic dermatomyositis complicated with cervical cancer: Successful treatment with direct hemoperfusion using polymyxin B-immobilized fiber column therapy

• Main Authors: Hidenori Ichiyasu, Yasumiko Sakamoto, Chieko Yoshida, Kazuhiko Sakamoto, Ryosuke Fujita, Go Nakayama, Hiroko Okabayashi, Sho Saeki, Shinichiro Okamoto, Hirotsugu Kohrogi
• Format: Article
• Language: English
• Published: Elsevier 2017-01-01
• Series: Respiratory Medicine Case Reports
• Subjects: Anti-melanoma differentiation-associated gene 5 antibody; Clinically amyopathic dermatomyositis; Rapidly progressive interstitial lung disease; Direct hemoperfusion using polymyxin B-immobilized fiber column; Cervical cancer
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007116301757

The anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is a marker of clinically amyopathic dermatomyositis (CADM) and rapidly progressive interstitial lung disease (ILD) with acute respiratory failure. A 35-year-old woman with cervical cancer showed Gottron's papules, severe hypoxemia, and diffuse ground-glass opacities on chest computed tomography. She was diagnosed with rapidly progressive ILD associated with CADM. Her serum was positive for the anti-MDA-5 antibody. Combination therapy with corticosteroids, immunosuppressants, and direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP) improved her respiratory dysfunction. Eventually, surgery for the cancer was performed successfully. This is the first case to demonstrate the efficacy of PMX-DHP for rapidly progressive ILD with anti-MDA-5 antibody-positive CADM and a malignancy.