Dermatomyositis with Rapidly Progressive Interstitial Lung Disease Treated with Rituximab: A Report of 3 Cases in Japan

Intern Med. 2017;56(11):1399-1403. doi: 10.2169/internalmedicine.56.7956. Epub 2017 Jun 1.

Abstract

We performed a retrospective chart review of three patients with hypomyopathic dermatomyositis and rapidly progressive interstitial lung disease. The patients were Japanese women of 71, 69, and 65 years of age. Two patients were anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive and 1 was anti-aminoacyl-tRNA synthetase (anti-ARS) antibody-positive. Their respiratory statuses deteriorated despite the administration of glucocorticoid, calcineurin inhibitors, and intravenous cyclophosphamide therapy. We subsequently administered rituximab. The anti-ARS antibody-positive patient survived, while 2 anti-MDA5 antibody-positive patients died.

Keywords: anti-ARS antibody; anti-MDA5 antibody; anti-PL-12 antibody; dermatomyositis; interstitial lung disease; rituximab.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amino Acyl-tRNA Synthetases / immunology
  • Autoantibodies
  • Calcineurin Inhibitors / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Dermatomyositis / complications*
  • Dermatomyositis / drug therapy*
  • Dermatomyositis / immunology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use*
  • Interferon-Induced Helicase, IFIH1 / immunology
  • Japan
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / immunology
  • Retrospective Studies
  • Rituximab / therapeutic use*

Substances

  • Autoantibodies
  • Calcineurin Inhibitors
  • Glucocorticoids
  • Immunologic Factors
  • Rituximab
  • Cyclophosphamide
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1
  • Amino Acyl-tRNA Synthetases