Successful treatment of interstitial pneumonia and pneumomediastinum associated with polymyositis during pregnancy with a combination of cyclophosphamide and tacrolimus : A case report

Okada, Rika; Miyabe, Yoshishige; Kasai, Shunsuke; Hashimoto, Kana; Yamauchi, Shuta; Yoshikawa, Manabu; Sumori, Keijirou; Nagasaka, Kenji

doi:10.2177/jsci.33.142

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…In another case report, a pregnant woman at 16 weeks of gestation had developed IP preceding anti Jo-1 positive ASS, and was treated with a combination of steroid pulse therapy and tacrolimus. The fetus did not survive since it was too small, and the maternal condition deteriorated (26). To the best of our knowledge, the present case study is the first reported case of a patient having been diagnosed with anti-MDA5-positive RP-ILD complicated with CADM.…”

Section: Discussionmentioning

confidence: 75%

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Case Report: Rapidly Progressive Interstitial Lung Disease in A Pregnant Patient With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis

Chen

Huang

et al. 2021

Front. Immunol.

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Dermatomyositis occurs extremely rarely during pregnancy. A number of studies in the published literature have documented how the outcome of pregnancy is poor for both mother and fetus. The present case study reports on a patient who was diagnosed with clinically amyopathic dermatomyositis complicated by interstitial lung disease during pregnancy, and was successfully treated with a combined immunosuppressant regimen. To the best of the authors’ knowledge, this is the first case study detailing how a pregnant woman with clinically amyopathic dermatomyositis with positive anti-melanoma differentiation-associated gene 5 antibody achieved complete remission after early intervention of combined immunosuppressive therapy without residual pulmonary interstitial changes.

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Section: Discussionmentioning

confidence: 75%

“…Examples of clinical case studies for treating pregnant patients with DM or PM, especially CADM, are relatively rare, and case studies of a similar nature that we were able to identify are shown in supplementary material (18,(26)(27)(28). Tomohiro et al (18).…”

Section: Discussionmentioning

confidence: 79%

Case Report: Rapidly Progressive Interstitial Lung Disease in A Pregnant Patient With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis

Chen

Huang

et al. 2021

Front. Immunol.

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“…It should be noted that the use of immunosuppressants for the treatment of IP does not ensure rapid improvement in patient condition. In a similar case report, a pregnant woman at 16 weeks of gestation had developed IP preceding PM and was treated with a combination of steroid pulse therapy and tacrolimus [ 11 ]. Due to that patient's worsening respiratory condition, the pregnancy was terminated in the 21st week of gestation to save the mother.…”

Section: Discussionmentioning

confidence: 99%

Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia

Shoji

Umegaki

Nishimoto

et al. 2017

Case Reports in Critical Care

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A 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse therapy for suspected interstitial pneumonia, the patient's condition worsened. Respiratory distress was slightly alleviated after the initiation of high-flow nasal cannula (HFNC) oxygen therapy (40 L/min, FiO2 40%). We suspected clinically amyopathic dermatomyositis (CADM) complicating rapidly progressive refractory interstitial pneumonia. In order to save the life of the patient, the use of combination therapy with immunosuppressants was necessary. The patient underwent emergency cesarean section and was immediately treated with immunosuppressants while continuing HFNC oxygen therapy. The neonate was treated in the neonatal intensive care unit. The patient's condition improved after 7 days of hospitalization; by this time, she was positive for myositis-specific autoantibodies and was diagnosed with interstitial pneumonia preceding dermatomyositis. This condition can be potentially fatal within a few months of onset and therefore requires early combination immunosuppressive therapy. This case demonstrates the usefulness of HFNC oxygen therapy for respiratory management as it negates the need for intubation and allows for various treatments to be quickly performed.

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“…6 The most frequently mentioned complication of DM/PM was interstitial lung disease. [19][20][21][22][23] The rate of cesarean delivery ranged from 23.3% 6 to 88.2% 5 (Supplementary Tables S1 and S2).…”

Section: Pregnancy In Dm/pmmentioning

confidence: 99%

Pregnancy in adult‐onset dermatomyositis/polymyositis: A systematic review

Tang

Zhou

Lan

et al. 2022

American J Rep Immunol

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Background: Idiopathic inflammatory myopathy (IIM) in pregnancy is uncommon but may result in complications for both mother and the fetus. Aim:In this systematic review, we summarized the current literature investigating outcomes of pregnancy related to the dermatomyositis/polymyositis (DM/PM) process. Content:We searched PubMed, Embase, Cochrane Library, and Web of Science databases and included 61 studies reporting the disease course, pregnancy outcomes, and management of both pregnancy and DM/PM in the final analysis.The specific information of 221 pregnancies was extracted and these pregnancies were divided into three distinct forms: pregnancies after disease onset (n = 159), pregnancies with new disease onset (n = 37), and pregnancies followed by postpartum onset (n = 25). In most cases, DM/PM disease activity remained stable or improved throughout pregnancy (80.2%) and the postpartum period (83.9%). Active DM/PM during pregnancy significantly increased the risk of stillbirth or neonatal death (12% vs. 1%, P = .005) and preterm birth (34.7% vs. 11%, P < .001). The rates of other poor outcomes (total fetal loss, low birth weight, and intrauterine growth retardation) were also increased in pregnancies with active disease. Mainstay treatments for active DM/PM during pregnancy are glucocorticoids and intravenous immunoglobins. Implications:The present results underline the importance of good control of myopathy in optimizing the pregnancy outcomes of women with DM/PM.

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Successful treatment of interstitial pneumonia and pneumomediastinum associated with polymyositis during pregnancy with a combination of cyclophosphamide and tacrolimus : A case report

Cited by 10 publications

References 21 publications

Case Report: Rapidly Progressive Interstitial Lung Disease in A Pregnant Patient With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis

Case Report: Rapidly Progressive Interstitial Lung Disease in A Pregnant Patient With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis

Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia

Pregnancy in adult‐onset dermatomyositis/polymyositis: A systematic review

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