Intravenous immunoglobulin contributes to the control of antimelanoma differentiation-associated protein 5 antibody-associated dermatomyositis with palmar violaceous macules/papules.
H Koguchi-YoshiokaHanako Koguchi-YoshiokaK IwamotoY MatsumuraT OgawaS InoueR WatanabeM FujimotoPublished in: The British journal of dermatology (2017)
Autoantibodies to melanoma differentiation-associated protein 5 (MDA5) are associated with a subset of patients with dermatomyositis (DM) who have rapidly progressive interstitial lung disease (RP-ILD) with poor prognosis. Intensive immunosuppressive therapy is initiated before irreversible lung damage can occur; however, there are few lines of evidence for the treatment of RP-ILD. Here, we report three cases of anti-MDA5 antibody-associated DM with RP-ILD in which the patients were treated with combined-modality therapy, including high-dose prednisolone, tacrolimus, intravenous cyclophosphamide and intravenous immunoglobulin (IVIG). In all three cases, serum ferritin levels, which are known to represent the disease activity of RP-ILD, were decreased after IVIG administration. IVIG might contribute to the control of the disease activity of anti-MDA5 antibody-positive DM. Moreover, palmar violaceous macules/papules around the interphalangeal joints, which was observed in all three cases in the incipient stage, might be a useful sign in suggesting a diagnosis of anti-MDA5 antibody-associated DM.
Keyphrases
- interstitial lung disease
- disease activity
- rheumatoid arthritis
- high dose
- systemic sclerosis
- systemic lupus erythematosus
- poor prognosis
- breast cancer cells
- rheumatoid arthritis patients
- ankylosing spondylitis
- low dose
- stem cell transplantation
- idiopathic pulmonary fibrosis
- juvenile idiopathic arthritis
- newly diagnosed
- end stage renal disease
- long non coding rna
- cell cycle arrest
- chronic kidney disease
- glycemic control
- prognostic factors
- ejection fraction
- oxidative stress
- stem cells
- bone marrow
- metabolic syndrome
- combination therapy
- replacement therapy
- insulin resistance
- smoking cessation