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Abstract
Case Report
A case of interstitial pneumonia associated with clinically amyopathic dermatomyositis successfully treated with multi-target therapy including rituximab
Tetsu Haraa Hiroyuki Shimadaa Shuta Yamauchia Yasuto Jina Hidetaka Majimab Reina Imasec
aDepartment of Respiratory Medicine, Hiratsuka Kyosai Hospital
bDepartment of Respiratory Medicine, Tokyo Medical and Dental University
cDepartment of Respiratory Medicine, Yokohama City Minato Red Cross Hospital
ABSTRACT
A 61-year-old woman was admitted to our hospital with dyspnea, heliotropic rash, and Gottron's sign. There was no muscle weakness. The chest computed tomographic scans showed subpleural patchy consolidation. The anti-MDA5 antibody test was positive. We diagnosed the patient with interstitial pneumonia associated with clinically amyopathic dermatomyositis (CADM) and treated with steroid pulse therapy, cyclosporin A (CyA), and intravenous cyclophosphamide (IVCY). However, the interstitial pneumonia worsened. We conducted polymyxin B direct hemoperfusion (PMX-DHP) on days 5 and 9. The respiratory failure improved temporarily. Rituximab (RTX) was added on day 14. After these treatments, the oxygenation of the blood and radiologic findings gradually improved.
KEYWORDS
Interstitial pneumonia Anti-MDA5 antibody Rituximab
Received 20 Dec 2018 ／ Accepted 15 Apr 2019
AJRS, 8(4): 259-263, 2019
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