Clinical Features of Anti-MDA5 Antibody-positive Rapidly Progressive Interstitial Lung Disease without Signs of Dermatomyositis

Intern Med. 2019 Mar 15;58(6):837-841. doi: 10.2169/internalmedicine.1516-18. Epub 2018 Nov 19.

Abstract

Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody is associated with rapidly progressive interstitial lung disease (RP-ILD) in patients with clinically amyopathic dermatomyositis (CADM) or dermatomyositis (DM). We herein report three Japanese cases of anti-MDA5 antibody-positive RP-ILD without signs of CADM or DM. High-resolution computed tomography revealed patchy or subpleural distribution of consolidations and/or ground-glass opacities accompanied by traction bronchiectasis. All patients succumbed to respiratory failure within two months. Anti-MDA5 antibody-positive RP-ILD without signs of CADM or DM should be included in the differential diagnosis of acute/subacute ILD. Measurement of anti-MDA5 antibody and an intensive immunosuppressive regimen might rescue these patients from RP-ILD.

Keywords: acute interstitial pneumonia; anti-melanoma differentiation-associated gene 5; clinically amyopathic dermatomyositis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies / blood*
  • Dermatomyositis / complications
  • Dermatomyositis / diagnosis*
  • Disease Progression
  • Fatal Outcome
  • Female
  • Humans
  • Interferon-Induced Helicase, IFIH1 / immunology*
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnosis*
  • Lung Diseases, Interstitial / immunology
  • Male

Substances

  • Autoantibodies
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1

Supplementary concepts

  • Amyopathic dermatomyositis