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Abstract
Case Report
A case of dermatomyositis double positive for anti-melanoma differentiation-associated gene 5 and anti-aminoacyl-tRNA synthetase antibodies with treatment-resistant myositis
Miho Fujiwaraa Hiromi Watanabea Mayu Godaa Keiichi Fujiwaraa Kousuke Otab Takuo Shibayamaa
aDepartment of Respiratory Medicine, National Hospital Organization Okayama Medical Center
bDepartment of Rheumatology, National Hospital Organization Okayama Medical Center
ABSTRACT
A 66-year-old man presented to our hospital because of fever, cough, and myalgia. Based on typical skin lesions, interstitial pneumonia, muscle pain, muscle weakness, and positivity for both anti-melanoma differentiation-associated gene 5 (anti-MDA5) and anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies, he was diagnosed with dermatomyositis-associated interstitial pneumonia. Although progression of the interstitial pneumonia was gradual, the myositis rapidly worsened. Treatment with steroid, tacrolimus, and cyclophosphamide was started. In addition to high-dose immunoglobulin therapy, we substituted ciclosporin A for tacrolimus, but he died on the 50th day of hospitalization due to complications of the fungal and cytomegalovirus infections. We report a rare case of dermatomyositis which was positive for both anti-MDA5 and anti-ARS antibodies.
KEYWORDS
Dermatomyositis Interstitial pneumonia Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody Anti-aminoacyl-tRNA synthetase (anti-ARS) antibody
Received 15 Nov 2023 ／ Accepted 10 May 2024
AJRS, 13(4): 148-154, 2024
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