Osawa Takeshi, Morimoto Kozo, Sasaki Yuka, Matsuda Shuichi, Yamana Kazunari, Yano Ryozo, Uchiyama Takashi, Goto Hajime
Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan.
Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan.
Intern Med. 2018 Feb 1;57(3):387-391. doi: 10.2169/internalmedicine.8335-16. Epub 2017 Nov 1.
We report the case of a 61-year-old woman with rapidly progressive interstitial lung disease caused by clinically amyopathic dermatomyositis. Both the serum ferritin and anti-melanoma differentiation-associated gene 5 (MDA5) antibody levels were elevated at the time of admission. Despite intensive treatment with corticosteroids, immunosuppressants, immunoglobulins and polymyxin B direct hemoperfusion, the patient died 75 days after symptom onset. Over the course of treatment, the anti-MDA5 antibody level continually decreased, while the serum ferritin level increased, suggesting that sequential measurements of the serum ferritin level might be useful for evaluating the treatment responsivity, irrespective of the anti-MDA5 antibody level.
我们报告了一例由临床无肌病性皮肌炎引起的快速进展性间质性肺病的61岁女性病例。入院时血清铁蛋白和抗黑色素瘤分化相关基因5（MDA5）抗体水平均升高。尽管使用皮质类固醇、免疫抑制剂、免疫球蛋白和多粘菌素B直接血液灌流进行了强化治疗，但患者在症状出现后75天死亡。在治疗过程中，抗MDA5抗体水平持续下降，而血清铁蛋白水平升高，这表明无论抗MDA5抗体水平如何，连续测量血清铁蛋白水平可能有助于评估治疗反应性。
