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Uncommon concurrent pulmonary infections: and in an Anti-MDA5 antibody-positive dermatomyositis patient.

Med Mycol Case Rep

March 2025

Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. was identified, leading to voriconazole initiation.

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There are several types of inflammatory myopathies, including juvenile dermatomyositis (JDM), which is characterized by muscle inflammation that can eventually lead to weakness. A devastating complication of JDM is macrophage activation syndrome (MAS), although reports of MAS in JDM patients are limited. Additionally, cases of JDM associated with positive anti-MDA5 are rare and represent a fatal subtype of inflammatory myopathies, with a significant risk of lung impairment.

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