Treatment of refractory anti-melanoma differentiation-associated gene 5 anbibody-positive dermatomyositis complicated by rapidly progressing interstitial pulmonary disease: Two case reports

Figure 1 Computed tomography findings of Case 2. A and B: Multiple patchy subpleural exudation, consolidation, and interstitial changes were observed in both lungs. Also, multiple infectious legions were noted, which were noticeably worse than before; C and D: Scattered flaked ground-glass shadows in both lungs and multiple cords in the lower lungs on admission were observed; E and F: Subpleural exudation and consolidation were observed to improve to a large extent after hormone therapy in combination with tocilizumab treatment.

Figure 2 Computed tomography findings of Case 1. A and B: Patchy exudation and interstitial changes were observed in both lungs on admission; C and D: After 4 wk of hormone and cyclophosphamide treatment, only mild subpleural gridded changes were observed in both lungs.

Figure 3 Regimen adopted for the treatment of Case 2. IVIG: Intravenous gamma globulin; Mpsl: Methylprednisolone; Tac: Tacrolimus; Oxy: Oxygenation support; SMZco: Sulfamethoxazole complex.