Anti‐MDA5 antibody dermatomyositis‐associated rapidly progressive interstitial lung disease patient complicated with mixed connective tissue disease: A case report

• Published in: International journal of rheumatic diseases Vol. 26; no. 6; pp. 1137 - 1142
• Main Authors: Wu, Hua‐Man, Liu, Xian‐hong, Deng, Li‐Ping, Lv, Feng‐Yuan, Zhang, Mei‐Xia, Luo, Jun‐Ping, Tian, Mao‐Liang, Deng, Zhi‐Ping
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2023
• Subjects: Antibodies; anti‐MDA5 antibody dermatomyositis; anti‐Ro52 antibody; Case reports; Coexistence; Connective tissue diseases; Dermatomyositis; Dyspnea; Elbow; Lung diseases; Mixed connective tissue disease; Myositis; prognosis; rapidly progressive interstitial lung disease; Respiration; anti-MDA5 antibody dermatomyositis; anti-Ro52 antibody; mixed connective tissue disease; prognosis; rapidly progressive interstitial lung disease
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.14575

Anti‐MDA5 antibody dermatomyositis (DM) is a special type of myositis, which can potentially cause rapidly progressive interstitial lung disease (RP‐ILD). Mixed connective tissue disease (MCTD) is a complex disease with different characteristics of autoimmune connective tissue disease, associated with ILD. Both are rare diseases, and few patients with both diseases have been reported. A 71‐year‐old woman complained of palpitations, with a 2 months history of rash around her hands, extensor surface of right elbow, and the nape of her neck. Subsequently, the patient had acute exacerbation of dyspnea and tachypnea. Anti‐Ro52, U1 RNP and MDA5 antibodies were positive; the presenting evidence was suggestive of anti‐MDA5+DM‐RP‐ILD complicated with MCTD. Our patient deteriorated rapidly and had a fatal outcome, despite “triple therapy” for RP‐ILD. This case illustrates that patients with coexisting anti‐MDA5+DM and MCTD have the former's typical clinical manifestations, and may develop ILD quickly rather than slowly as in MCTD, especially with the coexistence of anti‐Ro52 antibodies.