Successful Treatment of Rapidly Progressive Unclassifiable Idiopathic Interstitial Pneumonia with Anti-melanoma Differentiation-associated Gene-5 Antibody by Intensive Immunosuppressive Therapy

Intern Med. 2018 Apr 1;57(7):1039-1043. doi: 10.2169/internalmedicine.9553-17. Epub 2017 Dec 21.

Abstract

We describe a case of a woman who presented with a persistent cough, general fatigue, and a fever. Interstitial lung disease was rapidly progressive and resistant to high-dose steroid therapy. She tested positive for the presence of anti-melanoma differentiation-associated gene 5 (MDA-5) antibody, although she had no skin manifestations of dermatomyositis. She was eventually diagnosed with unclassifiable idiopathic interstitial pneumonia and was successfully treated with intensive immunosuppressive therapy including intravenous cyclophosphamide. To our knowledge, this is the first report of anti-MDA-5 antibody in a patient with idiopathic interstitial pneumonia.

Keywords: anti-MDA-5 antibody; idiopathic pneumonia with autoimmune features (IPAF); rapidly progressive interstitial lung disease; unclassifiable idiopathic interstitial pneumonia (UCIP).

Publication types

  • Case Reports

MeSH terms

  • Antibodies / genetics*
  • Cyclophosphamide / therapeutic use*
  • Female
  • Humans
  • Idiopathic Interstitial Pneumonias / complications
  • Idiopathic Interstitial Pneumonias / diagnostic imaging
  • Idiopathic Interstitial Pneumonias / drug therapy*
  • Idiopathic Pulmonary Fibrosis / diagnostic imaging
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Immunosuppressive Agents / therapeutic use*
  • Melanoma / genetics*
  • Melanoma / immunology*
  • Middle Aged
  • Treatment Outcome

Substances

  • Antibodies
  • Immunosuppressive Agents
  • Cyclophosphamide