Isono Taisuke, Nakajima Hiromi, Takano Kenji, Kobayashi Yoichi, Kawabata Yoshinori, Shimizu Yoshihiko, Takayanagi Noboru
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
Departments of Pathology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
Respir Med Case Rep. 2021 Jul 27;34:101491. doi: 10.1016/j.rmcr.2021.101491. eCollection 2021.
A 73-year-old woman who visited our hospital complaining of dry cough for three months was refractory to antimicrobial therapy. Chest computed tomography revealed subpleural consolidation. Specimens obtained from surgical lung biopsy revealed subpleural perilobular airspace organization and fibrosis. After the biopsy, mechanic's hand and Gottron's papules appeared, and anti-melanoma differentiation-associated gene 5 (MDA5) antibody was found to be positive. Subsequently, anti-MDA5 antibody measured in cryopreserved serum from her first admission proved to be positive. It is difficult to suspect the presence of anti-MDA-5 antibody in patients with interstitial lung disease without typical dermatomyositis symptoms or slow disease progression.
一名73岁女性因干咳3个月前来我院就诊，抗菌治疗无效。胸部计算机断层扫描显示胸膜下实变。手术肺活检获取的标本显示胸膜下小叶周围气腔组织化和纤维化。活检后，出现技工手和Gottron丘疹，且抗黑色素瘤分化相关基因5（MDA5）抗体检测呈阳性。随后，对其首次入院时冻存血清检测发现抗MDA5抗体也呈阳性。对于没有典型皮肌炎症状或疾病进展缓慢的间质性肺病患者，很难怀疑其存在抗MDA-5抗体。
