Serum ferritin correlates with activity of anti-MDA5 antibody-associated acute interstitial lung disease as a complication of dermatomyositis

Mod Rheumatol. 2011 Apr;21(2):223-7. doi: 10.1007/s10165-010-0371-x. Epub 2010 Nov 5.

Abstract

Dermatomyositis (DM) is occasionally complicated by interstitial lung disease. Acute/subacute interstitial pneumonia (A/SIP) with DM is intractable and life threatening. Clinically amyopathic dermatomyositis (C-ADM) is also reported to be complicated with A/SIP, especially in those patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody. In the present cases, we indicate that serum ferritin level correlated with activity of A/SIP with DM. Two patients, a 65-year-old woman and a 30-year-old woman, were diagnosed with anti-MDA5 antibody-associated A/SIP with DM. Serum ferritin was high, 1600 and 770 mg/dl, respectively, on admission. Immunosuppressive therapy ameliorated A/SIP in both cases. Similarly, serum ferritin was also decreasing. However, A/SIP was recurrent and progressive, and serum ferritin was also increasing again in one case. In conclusion, serum ferritin correlates with disease activity of anti-MDA5 antibody-associated A/SIP with DM. Intensity of treatment may be decided according to serum ferritin level.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • DEAD-box RNA Helicases / genetics
  • DEAD-box RNA Helicases / immunology*
  • Dermatomyositis / complications
  • Dermatomyositis / drug therapy
  • Dermatomyositis / immunology
  • Drug Monitoring
  • Female
  • Ferritins / blood*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon-Induced Helicase, IFIH1
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / immunology

Substances

  • Immunosuppressive Agents
  • Ferritins
  • IFIH1 protein, human
  • DEAD-box RNA Helicases
  • Interferon-Induced Helicase, IFIH1

Supplementary concepts

  • Amyopathic dermatomyositis