A case of treatment-resistant dysphagia and muscle weakness in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis
Sho Takuma Yoshiyuki Oyama Shogo Nakamura Rie Mori Masaki Ikeda Hideki Kusagaya
Department of Respiratory Medicine, Shizuoka Saiseikai General Hospital
A 46-year-old man complained of fever, cough and arthralgia. Based on a typical skin lesion and chest computed tomography (CT) findings, he was diagnosed with dermatomyositis complicated by interstitial pneumonia. Although he was positive for anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody, the interstitial pneumonia did not progress rapidly, and we started treatment with corticosteroids and ciclosporin A. Dysphagia and muscle weakness, however, progressed during the subacute course. Subsequently, we controlled them by intensifying treatment with high-dose corticosteroids, intravenous cyclophosphamide, intravenous immunoglobulin, and aggressive rehabilitation. This is a very rare case of anti-MDA5 antibody-positive dermatomyositis with treatment-resistant myositis.
Dermatomyositis (DM) Anti-melanoma differentiation-associated gene 5 antibody Muscle weakness Dysphagia Interstitial pneumonia
Received 15 Apr 2020 / Accepted 28 Aug 2020
AJRS, 9(6): 468-472, 2020