Rapidly progressive interstitial lung disease due to anti-MDA5 antibodies without skin involvement: a case report and literature review

Rheumatol Int. 2018 Jul;38(7):1293-1296. doi: 10.1007/s00296-018-3991-7. Epub 2018 Feb 7.

Abstract

Anti-MDA5 antibodies have been strongly associated with rapidly progressive interstitial lung disease (RP-ILD) in dermatomyositis (DM) patients, especially in the clinically amyopathic subset (CADM). We present a case of anti-MDA5 antibody-associated RP-ILD in a patient with arthritis but with no other clinical signs suggestive of DM or CADM successfully treated with a combination of cyclophosphamide, cyclosporine and corticoids. A review of the literature was also done. Despite its rarity, anti-MDA5 antibody-associated ILD should be suspected in cases of RP-ILD even without other signs of DM or CADM as prompt and aggressive treatment could improve prognosis.

Keywords: Anti-CADM-140 antibodies; Anti-MDA5 antibodies; Clinically amyopathic dermatomyositis; Dermatomyositis; Diffuse alveolar damage; Rapidly progressive interstitial lung disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Autoantibodies
  • Cyclosporine / therapeutic use
  • Dermatomyositis / immunology*
  • Female
  • Humans
  • Interferon-Induced Helicase, IFIH1 / immunology*
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / immunology*
  • Methylprednisolone / therapeutic use
  • Middle Aged

Substances

  • Anti-Inflammatory Agents
  • Autoantibodies
  • Cyclosporine
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1
  • Methylprednisolone