Suining Central Hospital, 127 Desheng West Road, Chuanshan, Suining, 629000, Sichuan, China.
Eur J Med Res. 2022 May 15;27(1):68. doi: 10.1186/s40001-022-00693-0.
Dermatomyositis is a rare idiopathic inflammatory disease with diverse presentations that can have varying degrees of cutaneous and systemic involvement. This phenotypic heterogeneity makes DM a therapeutic challenge. Some therapeutic drugs, such as hormones and immunosuppressants, have poor therapeutic effects. In recent years, tofacitinib has been reported to be effective in the treatment of dermatomyositis.
We report a case of anti-MDA5 antibody-positive dermatomyositis that was relieved after treatment with tofacitinib, during which gallbladder gangrene and suppurative cholecystitis occurred. After cholecystectomy, we continued to use tofacitinib and achieved a good therapeutic effect.
Tofacitinib is effective in the treatment of anti-MDA5 antibody-positive dermatomyositis, but the risk of infection is increased. It can still be used after infection control. Close follow-up should be performed during the use of tofacitinib.
皮肌炎是一种罕见的特发性炎症性疾病，临床表现多样，可累及皮肤和全身各系统，表现出不同程度的皮肤和系统受累。这种表型异质性使 DM 成为治疗上的挑战。一些治疗药物，如激素和免疫抑制剂，疗效不佳。近年来，有报道称托法替布对皮肌炎的治疗有效。
我们报告了一例抗 MDA5 抗体阳性皮肌炎，经托法替布治疗后缓解，在此期间发生胆囊坏疽和化脓性胆囊炎。胆囊切除术后，我们继续使用托法替布并取得了良好的治疗效果。
托法替布治疗抗 MDA5 抗体阳性皮肌炎有效，但感染风险增加。在感染控制后仍可使用。在使用托法替布期间应密切随访。
