Anti-MDA5 Antibody-Positive Dermatomyositis
Keywords:
Anti-MDA5 dermatomyositisAbstract
Dermatomyositis is an autoimmune disease, in which positive anti-melanoma differentiation associated gene 5 (anti-MDA5) is known as serious subtype, that might develop mucocutaneous lesions, vascular occlusion, and rapidly progressive interstitial lung disease. We report case series of three middle-aged female dermatomyositis patients with positive anti-MDA5 serology. All of the patients had mucocutaneous lesions, composed of cutaneous ulcers together with Gottron’s papules, and rapidly progressive interstitial lung disease. Histopathology of the ulcerated skin showed vascular thrombosis that was a common finding in this subtype. Patients were treated with several immunosuppressive drugs such as high-dose glucocorticoid, intravenous cyclophosphamide and azathioprine, however the disease progressed and two patients succumbed to their illnesses.
References
Dalakas MC. Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med 1991; 325: 1487–98.
Chow WH, Gridley G, Mellemkjaer L, McLaughlin JK, Olsen JH, Fraumeni JF Jr. Cancer risk following polymyositis and dermatomyositis: a nationwide cohort study in Denmark. Cancer Causes Control 1995; 6: 9-13.
Kurtzman DJB, Vleugels RA. Anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis: A concise review with an emphasis on distinctive clinical features. J Am Acad Dermatol 2018; 78: 776-85.
Hoa S, Troyanov Y, Fritzler MJ, et al. Describing and expanding the clinical phenotype of anti-MDA5-associated rapidly progressive interstitial lung disease: case series of nine Canadian patients and literature review. Scand J Rheumatol 2018; 47: 210-24.
Ponyi A, Constantin T, Garami M, et al. Cancer-associated myositis: clinical features and prognostic signs. Ann N Y Acad Sci 2005; 1051: 64-71.
Fathi M, Lundberg IE, Tornling G. Pulmonary complications of polymyositis and dermatomyositis. Semin Respir Crit Care Med 2007; 28: 451-8.
Gerami P, Schope JM, McDonald L, Walling HW, Sontheimer RD. A systematic review of adult-onset clinically amyopathic dermatomyositis (dermatomyositis siné myositis): A missing link within the spectrum of the idiopathic inflammatory myopathies. J Am Acad Dermatol 2006; 54: 597–613.
Sato S, Hirakata M, Kuwana M, et al. Autoantibodies to a 140-kd polypeptide, CADM-140, in Japanese patients with clinically amyopathic dermatomyositis. Arthritis Rheum 2005; 52: 1571-6.
Nakashima R, Hosono Y, Mimori T. Clinical significance and new detection system of autoantibodies in myositis with interstitial lung disease. Lupus 2016; 25: 925-33.
Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF. Cutaneous ulceration in dermatomyositis: association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease. Arthritis Care Res (Hoboken) 2015; 67: 667-72.
Fiorentino D, Chung L, Zwerner J, Rosen A, Casciola-Rosen L. The mucocutaneous and systemic phenotype of dermato-myositis patients with antibodies to MDA5 (CADM-140): a retrospective study. J Am Acad Dermatol 2011; 65: 25-34.
Funauchi M, Shimadsu H, Tamaki C, et al. Role of endothelial damage in the pathogenesis of interstitial pneumonitis in patients with polymyositis and dermatomyositis. J Rheumatol 2006; 33: 903–6.
Hall JC, Casciola-Rosen L, Samedy LA, et al. Anti-melanoma differentiation-associated protein 5-associated dermatomyositis: expanding the clinical spectrum. Arthritis Case Res (Hoboken) 2013; 65: 1307-15.
La Corte R, Lo Mo Naco A, Locaputo A, Doizani F, Trotta F. In patients with antisynthetase syndrome the occurrence of anti-Ro/SSA antibodies causes a more severe interstitial lung disease. Autaimmunity 2006; 39: 249-53.
Marie I, Hatron PY, Dominique S, et al. Short-term and long-term outcome of anti-Jo1-positive patients with anti-Ro52 antibody. Semin Arthritis Rheum 2012; 41: 890-9.
Tanizawa K, Handa T, Nakashima R, et al. The prognostic value of HRCT in myositis-associated interstitial lung disease. Respir Med 2013; 107: 745-52.
Gono T, Kawaguchi Y, Satoh T, et al. Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis. Rheumatology (Oxford) 2010; 49: 1713-9.
Gono T, Sato S, Kawaguchi Y, et al. Anti-MDA5 antibody, ferritin and IL-18 are useful for the evaluation of response to treatment in interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis. Rheumatology (Oxford) 2012; 51: 1563-70.
Sato S, Murakami A, Kuwajima A, et al. Clinical Utility of an Enzyme-Linked Immunosorbent Assay for Detecting Anti-Melanoma Differentiation-Associated Gene 5 Autoantibodies. PLoS One 2016; 11: e0154285.
Yashiro M, Asano T, Sato S, et al. Anti-MDA5 antibody-positive hypomyopathic dermatomyositis complicated with pneumomediastinum. Fukushima J Med Sci 2018; 64: 89–94.
Endo Y, Koga T, Suzuki T, et al. Successful treatment of plasma exchange for rapidly progressive interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis: A case report. Medicine (Baltimore) 2018; 97: e0436.
Downloads
Published
How to Cite
Issue
Section
License
เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น
