Suzuki Atsushi, Kondoh Yasuhiro, Taniguchi Hiroyuki, Tabata Kazuhiko, Kimura Tomoki, Kataoka Kensuke, Ono Kenzo, Hashisako Mikiko, Fukuoka Junya
Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Respir Med Case Rep. 2016 May 28;19:5-8. doi: 10.1016/j.rmcr.2016.05.008. eCollection 2016.
Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are specific indicators of patients with dermatomyositis, particularly clinically amyopathic dermatomyositis (CADM). CADM is occasionally accompanied by fatal, treatment-resistant, rapidly-progressive interstitial lung disease (RP-ILD). All previous reports showed that histopathological findings in RP-ILD with anti-MDA5 antibody-positive CADM indicated diffuse alveolar damage (DAD). This is the first report describing a non-DAD pattern in RP-ILD with anti-MDA5 antibody-positive CADM, which was improved by immunosuppressive therapy. This case may be a milder clinical phenotype than a typical DAD pattern in RP-ILD with anti-MDA5 antibody-positive CADM.
抗黑色素瘤分化相关基因5(MDA5)抗体是皮肌炎患者的特异性指标,尤其是临床无肌病性皮肌炎(CADM)患者。CADM偶尔会伴有致命的、治疗抵抗的、快速进展性间质性肺病(RP-ILD)。既往所有报告显示,抗MDA5抗体阳性的CADM合并RP-ILD的组织病理学表现为弥漫性肺泡损伤(DAD)。本文首次报道了抗MDA5抗体阳性的CADM合并RP-ILD的非DAD模式,该模式经免疫抑制治疗后得到改善。该病例可能是抗MDA5抗体阳性的CADM合并RP-ILD中比典型DAD模式更轻的临床表型。