Acta Medica Okayama volume71 issue4
2017-08 発行
Yamazaki, Kenji
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Wakabayashi, Hiroshi
Department of Rheumatology, Okayama City Hospital
Suganami, Yu
Department of General Internal medicine, Okayama City Hospital
Sano, Shinichi
Department of General Internal medicine, Okayama City Hospital
Wakunami, Yu
Department of General Internal medicine, Okayama City Hospital
Katayama, Takashi
Department of General Internal medicine, Okayama City Hospital
Deguchi, Kentaro
Department of Neurology, Okayama City Hospital
Nagotani, Shoko
Department of Neurology, Okayama City Hospital
Kishida, Masayuki
We report a case of a woman with typical dermatomyositis (DM) with skin manifestations, severe myalgia and muscle weakness complicated by interstitial lung disease (ILD) and pneumomediastinum. Pneumomediastinum persisted despite treatment with immunosuppressive therapy (steroids and cyclosporine). After the test for anti-melanoma differentiation-associated gene 5 (MDA5) antibody came out positive, we doubled the cyclosporine dose and her condition improved. Despite typical clinical features of DM, in cases complicated by pneumomediastinum or steroid resistance, measurement of anti-MDA5 antibody may be useful for immunosuppressant dose titration.
dermatomyositis
anti-melanoma differentiation-associated gene 5 antibody
interstitial lung disease
pneumomediastinum