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Abstract

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Article in Japanese

Case Report

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

ABSTRACT

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.

KEYWORDS

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

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