Sato Shinji, Nogi Shinichi, Sasaki Noriko, Chinen Naofumi, Honda Kiri, Saito Eiko, Wakabayashi Takayuki, Yamada Chiho, Suzuki Yasuo
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 259-1193, Japan.
Case Rep Rheumatol. 2014;2014:195617. doi: 10.1155/2014/195617. Epub 2014 Nov 9.
Here, we report a patient with sarcoidosis who developed edematous erythema and interstitial lung disease. At the initial visit, clinically amyopathic dermatomyositis (CADM) with rapidly progressive interstitial lung disease (RP-ILD) was suspected because he had progressive dyspnea but no muscle weakness. The presence of anti-CADM-140/MDA5 autoantibodies was immediately assessed to facilitate a precise diagnosis, with negative results. Thereafter, skin and transbronchial lung biopsies revealed noncaseating granuloma with Langhans giant cells in both specimens, leading to a diagnosis of sarcoidosis. In this case, clinical features of skin and lung were unable to distinguish DM (including CADM) from sarcoidosis, but the lack of anti-CADM-140/MDA5 antibody was useful for differentiating CADM with RP-ILD mimicking sarcoidosis from bona fide sarcoidosis.