The Serum Ferritin Level Is Associated with the Treatment Responsivity for Rapidly Progressive Interstitial Lung Disease with Amyopathic Dermatomyositis, Irrespective of the Anti-MDA5 Antibody Level

Intern Med. 2018 Feb 1;57(3):387-391. doi: 10.2169/internalmedicine.8335-16. Epub 2017 Nov 1.

Abstract

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.

Keywords: amyopathic dermatomyositis; anti-clinically amyopathic dermatomyositis 140 antibody; anti-melanoma differentiation-associated gene 5 antibody; ferritin; polymyxin B direct hemoperfusion; rapidly progressive interstitial lung disease.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Dermatomyositis / drug therapy*
  • Dermatomyositis / etiology*
  • Dermatomyositis / immunology
  • Fatal Outcome
  • Female
  • Ferritins / blood*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Interferon-Induced Helicase, IFIH1 / blood*
  • Interferon-Induced Helicase, IFIH1 / immunology
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / immunology
  • Middle Aged

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Ferritins
  • Interferon-Induced Helicase, IFIH1

Supplementary concepts

  • Amyopathic dermatomyositis