Anti-MDA5 Antibody-Positive Dermatomyositis in Emirati Patients: A Case Series Highlighting Clinical Variability
Abstract
Case series Patients: Male, 24-year-old • Male, 62-year-old • Male, 13-year-old Final Diagnosis: Dermatomyositis • interstitial lung disease Symptoms: Rash • respiratory deterioration • weakness Clinical Procedure: — Specialty: Rheumatology Objective: Unusual clinical course Background Melanoma differentiation-associated gene 5 (MDA5) is an intracellular sensor that detects double-stranded RNA viruses and triggers type I interferon pathways. Anti-MDA5 dermatomyositis (MDA5-DM) is an uncommon autoimmune subtype, often linked to rapidly progressive interstitial lung disease (RP-ILD) and sometimes presenting without obvious muscle weakness. It can appear in pulmonary, cutaneous–articular, or vascular forms, with RP-ILD carrying the worst prognosis. We describe 3 Emirati patients with MDA5-DM, each with a different clinical picture, organ involvement, and outcome. Case Reports Case 1: A 24-year-old man developed flu-like symptoms, rash, abnormal liver enzymes, and RP-ILD. His condition worsened despite high-dose steroids, cyclophosphamide, and plasma exchange; he required ECMO and died after 40 days. Case 2: A 62-year-old man with ILD presented with worsening dyspnea, weakness, and rash. He had high ferritin and lactate dehydrogenase levels, with positive anti-MDA5. He was treated with steroids, rituximab, nintedanib, and mycophenolate. High-resolution computerized tomography scans remained stable, but he required long-term oxygen after having pneumonia. Case 3: A 13-year-old…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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