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Recurrence of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis after long-term remission

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Title: Recurrence of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis after long-term remission
Authors: Endo, Yushiro / Koga, Tomohiro / Ishida, Midori / Fujita, Yuya / Tsuji, Sosuke / Takatani, Ayuko / Shimizu, Toshimasa / Sumiyoshi, Remi / Igawa, Takashi / Umeda, Masataka / Fukui, Shoichi / Nishino, Ayako / Kawashiri, Shin-ya / Iwamoto, Naoki / Ichinose, Kunihiro / Tamai, Mami / Nakamura, Hideki / Origuchi, Tomoki / Kuwana, Masataka / Hosono, Yuji / Mimori, Tsuneyo / Kawakami, Atsushi
Issue Date: 1-Jun-2018
Publisher: Lippincott Williams and Wilkins
Citation: Medicine, 97(26), art. no. e11024; 2018
Abstract: Rationale: Among all dermatomyositis (DM) patients, antimelanoma differentiation-Associated gene 5 antibody (anti-MDA5 Ab) positive patients have significantly poor short-Term mortality, whereas they experience less relapses over the long term after the remission. We report the case of a patient with anti-MDA5 Ab-positive clinically amyopathic dermatomyositis (CADM) with the recurrence of interstitial lung disease (ILD) after 7 years of remission. There has been no case report of an anti-MDA5 Ab-positive DM patient with the recurrence of ILD after 7 years of long-Term remission. Patient concerns: A 70-year-old Japanese woman was diagnosed with anti-MDA5 Ab-positive CADM and ILD. After achieving 7 years long-Term remission, she was admitted to our department with erythema on the fingers and interstitial pneumonia. Her anti-MDA5 Ab titer was elevated. Diagnoses: We diagnosed recurrent CADM complicated with ILD. Interventions: We successfully treated her with 1,000 mg of methyl-prednisolone pulse and intravenous cyclophosphamide therapy followed by prednisolone 50 mg/day and an increase of cyclosporine. Outcomes: After that treatment, the patient's skin symptoms and interstitial pneumonia were relieved. All laboratory investigations such as ferritin, the serum markers of interstitial pneumonia (i.e., SP-A, SP-D), and the titer of anti-MDA5 Ab showed signs of improvement. Lessons: Her case suggests that careful physical examinations and monitoring the serum markers are important even after long-Term remission is achieved.
Keywords: anti-MDA5 antibody / clinically amyopathic dermatomyositis / dermatomyositis / interstitial pneumonia
URI: http://hdl.handle.net/10069/38535
ISSN: 00257974
DOI: 10.1097/MD.0000000000011024
Rights: © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/38535

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