Spontaneous pneumomediastinum in a dermatomyositis patient with anti-melanoma differentiation-associated gene-5 antibody and interstitial lung disease despite an initial response to immunosuppressant.
Chiu Wai Shirley ChanHo Yin ChungChak Sing LauHelen H L TsangPublished in: International journal of rheumatic diseases (2017)
We report a 24-year-old man with anti-melanoma differentiation-associated gene-5 (MDA5) antibody-positive dermatomyositis (DM) and interstitial lung disease (ILD) who developed spontaneous pneumomediastinum. By comparing serial thoracic high-resolution computed tomography scans, we demonstrated the distinct time course showing a paradoxical occurrence of pneumomediastinum despite a radiological improvement of ILD. Our case shows that pneumomediastinum in DM can occur regardless of associated ILD and it is a serious complication that should be considered in DM patients presenting with pulmonary manifestations. Cutaneous vasculopathy may be associated with pneumomediastinum and could potentially be a useful indicator of future disease.
Keyphrases
- interstitial lung disease
- systemic sclerosis
- computed tomography
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- high resolution
- genome wide
- magnetic resonance imaging
- positron emission tomography
- risk assessment
- pulmonary hypertension
- spinal cord
- case report
- genome wide identification
- type diabetes
- dna methylation
- skin cancer
- magnetic resonance
- contrast enhanced
- disease activity
- cell death
- adipose tissue
- dual energy
- signaling pathway
- spinal cord injury
- current status
- image quality
- insulin resistance
- pet ct