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Abstract

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Article in Japanese

Case Report

A case of anti-PL-7 antibody-positive dermatomyositis–interstitial pneumonia with lung cancer

Kohei Iwasakia,b  Tomoyoshi Itohb  Masato Shinokib  Kanako Tamurab  Yuya Inadab  Kazuhiro Yanagiharac,d 

aDepartment of Respiratory Medicine, Graduate School of Medicine, Osaka City University
bDepartment of Respiratory Medicine, Kansai Electric Power Hospital
cDepartment of Medical Oncology, Kansai Electric Power Hospital
dDepartment of Clinical Oncology, Kansai Electric Power Medical Research Institute

ABSTRACT

A 68-year-old Japanese man was admitted to our hospital complaining of a one-month history of dyspnea and dry cough. He had eruptions on his face and extremities and severe acute respiratory failure. On laboratory tests, ferritin and KL-6 levels were high, and antibodies to anti-aminoacyl-tRNA synthetase (anti-PL-7 antibody) were present. Chest computed tomography showed ground-glass opacities in both lower lobes with volume loss and traction bronchiectasis, and a mass in the right lower lobe. Anti-PL-7 antibody-positive dermatomyositis–rapidly progressive interstitial pneumonia and lung cancer were diagnosed. The pulmonary infiltration seen on chest X-ray improved gradually after intensive therapy consisting of noninvasive positive pressure ventilation, pulse methylprednisolone, pulse cyclophosphamide, and cyclosporine A. After confirming that his respiratory status was stable, transbronchial biopsy was performed, and squamous cell lung cancer cT4N0M0 Stage III A was diagnosed. Anti-cancer drug treatment resulted not only in tumor shrinkage, but also in improvement of ground-glass opacities, the serum ferritin level, and pulmonary function. This case suggests that treatment of lung cancer with anti-aminoacyl-tRNA synthetase (anti-PL-7 antibody)-positive dermatomyositis–interstitial pneumonia is effective for control of interstitial pneumonia.

KEYWORDS

Anti-PL-7 antibody  Anti-aminoacyl-tRNA synthetase syndrome (ASS)  Interstitial pneumonia  Lung cancer 

Received 19 Aug 2020 / Accepted 6 Jan 2021

AJRS, 10(3): 293-298, 2021

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