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BMC Pulm Med
. 2020 Nov 19;20(1):304.
doi: 10.1186/s12890-020-01335-z.
COVID-19 or clinical amyopathic dermatomyositis associated rapidly progressive interstitial lung disease? A case report
Mengke Cao 1 2 , Shuangshuang Zhang 3 , Dejie Chu 4 , Ming Xiao 1 , Xiaohong Liu 5 , Lingling Yu 1 , Jing Li 1 , Yi Huang 1 , Fang Fang 6
Affiliations
- PMID: 33213393
- DOI: 10.1186/s12890-020-01335-z
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: Anti-Ro52 antibody; COVID-19; Clinical amyopathic dermatomyositis; Gottron’s papules; Gottron’s sign; Rapidly progressive interstitial lung disease.