Treatment of refractory anti-melanoma differentiation-associated gene 5 anbibody-positive dermatomyositis complicated by rapidly progressing interstitial pulmonary disease:Two case reports  

作　　者：Qiao-Hong Wang Li-Heng Chen 

机构地区：[1]Department of Rheumatology,Second Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310009,Zhejiang Province,China [2]Department of Endocrinology,Fourth Affiliated Hospital,College of Medicine,Zhejiang University,Yiwu 322000,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第22期5351-5357,共7页世界临床病例杂志

摘　　要：BACKGROUND Anti-melanoma differentiation-associated gene 5 antibody-positive(anti-MDA5 Ab+)dermatomyositis complicated with rapidly progressive interstitial lung disease(anti-MDA5 Ab+DM-RP-ILD)has an unclear underlying mechanism with no recommended unified treatment plan.Herein,one of the cases that we report(Case 2)was successfully treated with tocilizumab despite having lung infection.CASE SUMMARY Case 1 was a 30-year-old woman who was admitted due to recurrent rash for 5 mo,fever and cough for 1 mo,and chest tightness for 3 d.She was diagnosed with non-myopathic dermatomyositis(anti-MDA5 Ab+)and interstitial pneumonia,and was treated with the combination of hormone therapy and cyclophosphamide followed by oral tacrolimus.Case 2 was a 31-year-old man admitted due to systemic rash accompanied by muscle weakness of limbs for more than 1 mo,and chest tightness and dry cough for 4 d.He was diagnosed with dermatomyositis(anti-MDA5 Ab+)and acute interstitial pneumonia with Pneumocystis jirovecii and Aspergillus fumigatus infections and was treated with hormone therapy(without cyclophosphamide)and the combination of tocilizumab and tacrolimus.The condition of both patients eventually improved and they were discharged and showed clinically stable condition at the latest follow-up.CONCLUSION Tocilizumab could be a salvage treatment for patients with anti-MDA5 Ab+DMRP-ILD who are refractory to intensive immunosuppression.

关 键 词：Anti-melanoma differentiation-associated gene 5 antibody-positive DERMATOMYOSITIS Progressive interstitial lung disease Interstitial lung disease Tocilizumab Case report 

分 类 号：R593.26[医药卫生—内科学]