COVID-19 or clinical amyopathic dermatomyositis associated rapidly progressive interstitial lung disease? A case report
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CASE REPORT
Open Access
COVID-19 or clinical amyopathic dermatomyositis associated rapidly progressive interstitial lung disease? A case report Mengke Cao1,2†, Shuangshuang Zhang3†, Dejie Chu4†, Ming Xiao1, Xiaohong Liu5, Lingling Yu1, Jing Li1, Yi Huang1 and Fang Fang1*
Abstract Background: Coronavirus disease 2019 (COVID-19) has reach pandemic proportions globally. For patients with symptoms of fever and cough accompanied by rapid lung damage progression, COVID-19 needs to be distinguished from interstitial lung disease (ILD) attributed to connective tissue disease (CTD), especially dermatomyositis (DM)/clinical amyopathic dermatomyositis (CADM) associated rapidly progressive interstitial lung disease (RP-ILD). Case presentation: We report a case of a woman observed with fever, cough, and rapid lung damage during the epidemic. The patient had a suspicious epidemiological history, and her chest CT scans showed lung damage similar to that caused by COVID-19, but anti-Ro52 antibody was strongly positive. She was diagnosed with CADM associated RP-ILD and died 1 month later. Conclusions: During the COVID-19 epidemic, it is critical to carefully assess patients with CTD related ILD, especially RP-ILD associated with CADM. Repeated nucleic acid tests for COVID-19 are necessary to achieve accurate case diagnosis. High-resolution CT (HRCT) of the chest is presently deemed an inefficient technique to distinguishing between COVID-19 and CADM associated RP-ILD. The characteristic rashes of dermatomyositis require careful observation and can often provide diagnostic clues. For patients with CADM, a high titers of anti-Ro52 antibody may be related to the pathogenesis of RP-ILD, suggesting a poor prognosis. Keywords: Clinical amyopathic dermatomyositis, Rapidly progressive interstitial lung disease, COVID-19, Anti-Ro52 antibody, Gottron’s sign, Gottron’s papules
* Correspondence: fht291@sina.com † Mengke Cao, Shuangshuang Zhang and Dejie Chu contributed equally to this work. 1 Department of Dermatology, Shanghai Eighth People’s Hospital, 8 Caobao Road, Xuhui District, Shanghai 200235, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Cre
