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Br J Dermatol ; 177(5): 1442-1446, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28346662

RESUMEN

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.


Asunto(s)
Dermatomiositis/prevención & control , Dermatosis de la Mano/prevención & control , Inmunoglobulinas Intravenosas/uso terapéutico , Helicasa Inducida por Interferón IFIH1/inmunología , Enfermedades Pulmonares Intersticiales/prevención & control , Anciano , Antiinflamatorios/administración & dosificación , Autoanticuerpos/sangre , Terapia Combinada , Ciclofosfamida/administración & dosificación , Femenino , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Prednisolona/administración & dosificación , Tacrolimus/administración & dosificación , Resultado del Tratamiento
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