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Spontaneous pneumomediastinum in a dermatomyositis patient with anti‐melanoma differentiation‐associated gene‐5 antibody and interstitial lung disease despite an initial response to immunosuppressant
Author(s) -
Chan Chiu Wai Shirley,
Chung Ho Yin,
Lau Chak Sing,
Tsang Helen H. L.
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13112
Subject(s) - medicine , pneumomediastinum , dermatomyositis , interstitial lung disease , complication , disease , pathology , lung
We report a 24‐year‐old man with anti‐melanoma differentiation‐associated gene‐5 ( MDA 5) antibody‐positive dermatomyositis ( DM ) and interstitial lung disease ( ILD ) who developed spontaneous pneumomediastinum. By comparing serial thoracic high‐resolution computed tomography scans, we demonstrated the distinct time course showing a paradoxical occurrence of pneumomediastinum despite a radiological improvement of ILD . Our case shows that pneumomediastinum in DM can occur regardless of associated ILD and it is a serious complication that should be considered in DM patients presenting with pulmonary manifestations. Cutaneous vasculopathy may be associated with pneumomediastinum and could potentially be a useful indicator of future disease.