Rapidly progressive interstitial lung disease in patients with anti-melanoma differentiation-associated gene 5-positive dermatomyositis: serial changes on HRCT.


Journal

Emergency radiology
ISSN: 1438-1435
Titre abrégé: Emerg Radiol
Pays: United States
ID NLM: 9431227

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 05 05 2022
accepted: 25 07 2022
pubmed: 3 8 2022
medline: 11 11 2022
entrez: 2 8 2022
Statut: ppublish

Résumé

Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibodies in patients with dermatomyositis are associated with rapidly progressive interstitial lung disease (RP-ILD). Computed tomography (CT) plays a central role in the diagnosis of RP-ILD and may help characterize the temporal changes. We report five anti-MDA5-positive dermatomyositis patients with serial CT scans spanning their acute RP-ILD disease course. Our case series highlights the variable imaging pattern that can manifest in this setting, including diffuse alveolar damage and nonspecific interstitial pneumonia patterns. Three patients in our series died within 4 months of their disease onset, whereas the other two patients survived. The serial CT changes in anti-MDA5 disease are dynamic and variable; therefore, it is imperative to maintain a broad differential when faced with these HRCT patterns to improve the diagnosis and management of this underrecognized entity.

Sections du résumé

BACKGROUND BACKGROUND
Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibodies in patients with dermatomyositis are associated with rapidly progressive interstitial lung disease (RP-ILD). Computed tomography (CT) plays a central role in the diagnosis of RP-ILD and may help characterize the temporal changes.
METHODS METHODS
We report five anti-MDA5-positive dermatomyositis patients with serial CT scans spanning their acute RP-ILD disease course.
RESULTS RESULTS
Our case series highlights the variable imaging pattern that can manifest in this setting, including diffuse alveolar damage and nonspecific interstitial pneumonia patterns. Three patients in our series died within 4 months of their disease onset, whereas the other two patients survived.
CONCLUSION CONCLUSIONS
The serial CT changes in anti-MDA5 disease are dynamic and variable; therefore, it is imperative to maintain a broad differential when faced with these HRCT patterns to improve the diagnosis and management of this underrecognized entity.

Identifiants

pubmed: 35918568
doi: 10.1007/s10140-022-02080-y
pii: 10.1007/s10140-022-02080-y
doi:

Substances chimiques

Interferon-Induced Helicase, IFIH1 EC 3.6.4.13
Autoantibodies 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

961-967

Subventions

Organisme : NIAMS NIH HHS
ID : K23 AR075898
Pays : United States

Informations de copyright

© 2022. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).

Références

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Auteurs

Minsoo Kim (M)

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Samuel Harvey (S)

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Sonye K Danoff (SK)

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Christopher A Mecoli (CA)

Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Jemima Albayda (J)

Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Julie J Paik (JJ)

Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Lisa Christopher-Stine (L)

Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Peter B Illei (PB)

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Cheng Ting Lin (CT)

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. clin97@jhmi.edu.

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