Understanding and managing anti-MDA 5 dermatomyositis, including potential COVID-19 mimicry

Pankti Mehta, Pedro M Machado, Latika Gupta

Research output: Contribution to journalReview articlepeer-review

Abstract

Anti-Melanoma Differentiation-Associated gene 5 (MDA-5) Dermatomyositis (MDA5, DM) is a recently identified subtype of myositis characteristically associated with Rapidly Progressive Interstitial Lung Disease (RP-ILD) and unique cutaneous features. We reviewed PubMed, SCOPUS and Web of Science databases and selected 87 relevant articles after screening 1485 search results, aiming to gain a better understanding of the pathophysiology, clinical features, diagnosis, and treatment approaches of anti-MDA-5 DM described in the literature. The etiopathogenesis is speculatively linked to an unidentified viral trigger on the background of genetic predisposition culminating in an acquired type I interferonopathy. The clinical phenotype is highly varied in different ethnicities, with new clinical features having been recently described, expanding the spectrum of cases that should raise the suspicion of anti-MDA-5 DM. Unfortunately, the diagnosis is frequently missed despite excessive mortality, calling for wider awareness of suspect symptoms. RP ILD is the major determinant of survival, treatment being largely based on observational studies with recent insights into aggressive combined immunosuppression at the outset.

Original languageEnglish
Pages (from-to)1021-1036
Number of pages16
JournalRheumatology International
Volume41
Issue number6
DOIs
Publication statusPublished - Jun 2021

Keywords

  • COVID-19/diagnosis
  • Dermatomyositis/diagnosis
  • Disease Progression
  • Exanthema/diagnosis
  • Female
  • Humans
  • Interferon-Induced Helicase, IFIH1
  • Lung Diseases, Interstitial/diagnosis
  • Male
  • Prevalence
  • SARS-CoV-2

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