Two cases with autoantibodies to small ubiquitin-like modifier activating enzyme: A potential unique subset of dermatomyositis-associated interstitial lung disease

Int J Rheum Dis. 2019 Aug;22(8):1582-1586. doi: 10.1111/1756-185X.13593. Epub 2019 May 2.

Abstract

The presence of anti-aminoacyl tRNA synthetase (ARS) or anti-melanoma differential-associated gene 5 (MDA5) is strongly related to interstitial lung disease (ILD) in patients with dermatomyositis (DM). Several studies suggest a potential relationship between ILD and anti-small ubiquitin-like modifier activating enzyme (SAE) antibody in DM patients, but detailed clinical characteristics of anti-SAE-associated ILD still remain unknown. We have experienced 2 cases who were positive for anti-SAE antibody, who presented with ILD in the context of clinically amyopathic DM. These 2 patients had the following common ILD characteristics: an insidious course with preserved pulmonary function; a limited extent of pulmonary lesions with subpleural peripheral-dominant small ground glass opacity/consolidation on high-resolution computed tomography; and a favorable treatment response. These findings suggest that anti-SAE-associated ILD is unique in terms of clinical and imaging features and differs from ILD associated with anti-ARS or anti-MDA5 antibody.

Keywords: anti-small ubiquitin-like modifier activating enzyme antibody; dermatomyositis; human leukocyte antigen; interstitial lung disease.

Publication types

  • Case Reports

MeSH terms

  • Amino Acyl-tRNA Synthetases / immunology
  • Autoantibodies / blood*
  • Dermatomyositis / diagnosis
  • Dermatomyositis / drug therapy
  • Dermatomyositis / enzymology
  • Dermatomyositis / immunology*
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Interferon-Induced Helicase, IFIH1 / immunology
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / enzymology
  • Lung Diseases, Interstitial / immunology*
  • Male
  • Middle Aged
  • Small Ubiquitin-Related Modifier Proteins / immunology*
  • Treatment Outcome

Substances

  • Autoantibodies
  • Glucocorticoids
  • Small Ubiquitin-Related Modifier Proteins
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1
  • Amino Acyl-tRNA Synthetases