Rheumatoid Arthritis Complicated with Anti-melanoma Differentiation-associated Gene 5 Antibody-positive Interstitial Pneumonia

Intern Med. 2019 Mar 1;58(5):737-742. doi: 10.2169/internalmedicine.1613-18. Epub 2018 Oct 17.

Abstract

Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are frequently detected in amyopathic dermatomyositis with rapidly progressive interstitial lung disease (RP-ILD). However, the presence of anti-MDA5 antibodies in other connective tissue diseases is not well known. We herein report a case of rheumatoid arthritis complicated with refractory anti-MDA5 antibody-positive ILD. A 75-year-old Japanese woman was referred to our hospital for refractory ILD. Serological testing was positive for anti-MDA5 antibody without any muscle or skin lesions. Immunosuppressive therapy (prednisolone and tacrolimus) ameliorated her symptoms as well as ILD. Anti-MDA5 antibody-positive ILD, as well as dermatomyositis with RP-ILD, can occur in patients with rheumatoid arthritis.

Keywords: anti-MDA5 antibody; interstitial lung disease; rheumatoid arthritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology
  • Autoantibodies / blood*
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon-Induced Helicase, IFIH1 / immunology*
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / etiology*
  • Lung Diseases, Interstitial / immunology
  • Prednisolone / therapeutic use
  • Radiography
  • Tacrolimus / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Autoantibodies
  • Glucocorticoids
  • Immunosuppressive Agents
  • Prednisolone
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1
  • Tacrolimus