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CASE REPORT article

Front. Pediatr.
Sec. Pediatric Rheumatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1497168

Successful tocilizumab treatment for rapidly progressive interstitial lung disease with anti-MDA5 positive juvenile dermatomyositis: a case report and literature review

Provisionally accepted
Lingzhi Qiu Lingzhi Qiu *Xiaoyan Shao Xiaoyan Shao *Le Ma Le Ma *Zhidan Fan Zhidan Fan *Haiguo Yu Haiguo Yu *
  • Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China

The final, formatted version of the article will be published soon.

    Background: Currently, there is no established integrated treatment regimen for anti-melanoma differentiation-associated gene 5 (anti-MDA5) positive juvenile dermatomyositis (JDM) complicated by rapidly progressive interstitial lung disease (RP-ILD). We present a case of refractory anti-MDA5 positive JDM with RP-ILD that was successfully treated with a combination of tocilizumab and plasma exchange, along with a review of relevant literature.Methods: A literature review was conducted to gain insights into the clinical features and treatments strategies for refractory anti-MDA5 positive JDM complicated by RP-ILD.Results: We report a case of successful management of anti-MDA5 positive JDM complicated by RP-ILD through the use of a combination of immunosuppressive agents, plasma exchange, and tocilizumab.Conclusion: Tocilizumab may serve as an effective adjunctive treatment for patients with refractory anti-MDA5 positive JDM complicated by RP-ILD who do not respond to conventional intensive immunosuppressive therapies.

    Keywords: Anti-MDA5, juvenile dermatomyositis, Rapidly progressive interstitial lung disease, tocilizumab, Plasma Exchange

    Received: 16 Sep 2024; Accepted: 29 Oct 2024.

    Copyright: © 2024 Qiu, Shao, Ma, Fan and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lingzhi Qiu, Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China
    Xiaoyan Shao, Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China
    Le Ma, Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China
    Zhidan Fan, Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China
    Haiguo Yu, Department of Rheumatology and Immunology, Nanjing Children's Hospital, Nanjing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.