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Recurrence of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis after long-term remission: A case report.

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.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Endo Y,Koga T,Ishida M,Fujita Y,Tsuji S,Takatani A,Shimizu T,Sumiyoshi R,Igawa T,Umeda M,Fukui S,Nishino A,Kawashiri SY,Iwamoto N,Ichinose K,Tamai M,Nakamura H,Origuchi T,Kuwana M,Hosono Y,Mimori T,Kawakami A

doi

10.1097/MD.0000000000011024

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

e11024

issue

26

eissn

0025-7974

issn

1536-5964

pii

00005792-201806290-00003

journal_volume

97

pub_type

杂志文章

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