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CASE REPORT article
Front. Pharmacol.
Sec. Inflammation Pharmacology
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1472667
Mycophenolate Mofetil after Tacrolimus for Refractory Clinically Amyopathic Dermatomyositis: A Case Report
Provisionally accepted
Gui-Chen Ling
1*
Chang Su
1,2*
Xia Qiu
1,2*
Jia-Wei Liu
3*
Min Xiao
1,2*
Yu-Ya Xiao
1,2*
Shuo Yang
1*
Jian-Yong Zhang
1,2*
Jing-Jing Xie
1,2*- 1 The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
- 2 The Department of Rheumatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
- 3 The Department of Traditional Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
Dermatomyositis (DM) positive for anti-melanoma differentiation-associated gene 5 (MDA5) antibodies, mainly when linked with rapidly progressive interstitial lung disease (RP-ILD), is considered a refractory disease. Our report describes a critical case of clinically amyopathic dermatomyositis (CADM) with RP-ILD that tested positive for both anti-MDA5 and anti-Ro-52 antibodies. The patient showed a limited response to a combined therapy regimen of prednisone, iguratimod, and tacrolimus. However, after adjunct therapy with mycophenolate mofetil (MMF), the patient's condition was controlled, his serum KL-6 levels decreased, and anti-MDA5 antibodies became negative. During the 68-week follow-up, the patient's condition remained stable, with a satisfactory quality of life. This report also discusses the potential role of inflammatory cytokines in the pathophysiology of CADM and RP-ILD. Further research is required to confirm these results and investigate the application of MMF in maintenance therapy for CADM-associated RP-ILD.
Keywords: anti-MDA5-associated dermatomyositis, Cytokine profiles, Rapidly progressive interstitial lung disease, Mycophenolate mofetil, Clinically amyopathic dermatomyositis (CADM)
Received: 29 Jul 2024; Accepted: 18 Oct 2024.
Copyright: © 2024 Ling, Su, Qiu, Liu, Xiao, Xiao, Yang, Zhang and Xie. 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:
Gui-Chen Ling, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Chang Su, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Xia Qiu, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Jia-Wei Liu, The Department of Traditional Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
Min Xiao, The Department of Rheumatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
Yu-Ya Xiao, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Shuo Yang, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Jian-Yong Zhang, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
Jing-Jing Xie, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
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