著者
Eiko Kawakami Tomohisa Uchida Naoki Iwamoto Kazusato Hara Kazuhiro Egashira Atsushi Kawakami
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1621-23, (Released:2023-05-17)
参考文献数
17

We herein report a case of melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis that developed in a patient with refractory gingivitis. The diagnosis of anti-MDA5 antibody-positive dermatomyositis was made based on a characteristic skin rash, weakness of proximal muscles, interstitial pneumonia, and positivity for anti-MDA5 antibody. The patient was started on triple therapy with high-dose prednisolone, tacrolimus, and intravenous cyclophosphamide. After treatment, the refractory gingivitis disappeared, and the other skin rash and interstitial lung disease also improved. In the diagnosis and treatment of anti-MDA5 antibody-positive dermatomyositis, it is necessary to pay attention to the intraoral findings, including the gingiva.
著者
Shiho Toyama Ayuko Takatani Tomohiro Koga Mizuna Eguchi Momoko Okamoto Sosuke Tsuji Yushiro Endo Toshimasa Shimizu Remi Sumiyoshi Takashi Igawa Shin-ya Kawashiri Naoki Iwamoto Kunihiro Ichinose Mami Tamai Hideki Nakamura Tomoki Origuchi Masako Furuyama Maiko Tabuchi Shinichiro Kobayashi Kengo Kanetaka Mikiko Hashisako Kuniko Abe Daisuke Niino Shinya Sato Yasushi Miyazaki Atsushi Kawakami
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.2782-19, (Released:2019-07-22)
参考文献数
20
被引用文献数
1

A 71-year-old woman being treated with methotrexate (MTX) and tacrolimus (TAC) for rheumatoid arthritis (RA) was admitted to our hospital and underwent surgery for gastric perforation and peritonitis. An endoscopic examination six days post-surgery showed an extensive ulcer in the stomach, and a biopsy revealed diffused large B-cell lymphoma. We diagnosed her with immunodeficiency-associated lymphoproliferative disorder (LPD) and discontinued the MTX and TAC. She underwent gastrectomy due to stenosis approximately two months after the first operation, but the histopathological findings of lymphoma had disappeared. LPD should be considered as a potential cause of gastric perforation during RA treatment.