Combined usage of extracorporeal membrane oxygenation and double filtration plasmapheresis in amyopathic dermatomyositis patient with severe interstitial lung disease: A case report.
|Abstract||We report a man with amyopathic dermatomyositis (ADM) complicated by severe interstitial lung disease (ILD) received extracorporeal membrane oxygenation (ECMO) in combination with double filtration plasmapheresis (DFPP). This is the first report of the utility of ECMO in combination with DFPP in ADM related ILD in adults.|
A 34-year-old man with amyopathic dermatomyositis and rapidly progressive dyspnea with facial swelling. Diagnosis: pneumomediastinum and subcutaneous emphysema secondary to amyopathic dermatomyositis-associated interstitial lung disease.
|Publication Year Start||2018-01-01|
PMID- 29851838 OWN - NLM STAT- MEDLINE DCOM- 20180612 LR - 20180612 IS - 1536-5964 (Electronic) IS - 0025-7974 (Linking) VI - 97 IP - 22 DP - 2018 Jun TI - Combined usage of extracorporeal membrane oxygenation and double filtration plasmapheresis in amyopathic dermatomyositis patient with severe interstitial lung disease: A case report. PG - e10946 LID - 10.1097/MD.0000000000010946 [doi] AB - RATIONALE: We report a man with amyopathic dermatomyositis (ADM) complicated by severe interstitial lung disease (ILD) received extracorporeal membrane oxygenation (ECMO) in combination with double filtration plasmapheresis (DFPP). This is the first report of the utility of ECMO in combination with DFPP in ADM related ILD in adults. PATIENT CONCERNS: A 48-year-old man who was previously healthy had a 2-month history of cough and shortness of breath, which aggravated in 5 days. DIAGNOSES: Amyopathic dermatomyositis and complicated by severe interstitial lung disease. INTERVENTIONS: ECMO was giving when the patient suffered acute respiratory failure. Though corticosteroids was giving, primary disease was still developing with relapses of spontaneous pneumomediastinum and pneumothorax. Then, DFPP treatment was initiated. OUTCOME: After the treatments above, the patient's clinical condition improved with the reduction of bilateral interstitial infiltrates and improvement of lung compliance. Unfortunately, he discontinued the treatment because of the financial problem. LESSONS: When get a rapid progressive interstitial lung disease for no apparent reason, amyopathic dermatomyositis should be considered, especially with suspected skin lesions. ECMO, in combination with DFPP, should be considered as a supportive therapy and initiated early in patients in acute respiratory failure secondary to ADM-ILD. Prompt initiation of DFPP in dermatomyositis patients with ILD might help reduce the occurrence of spontaneous pneumomediastinum or pneumothorax. FAU - Huang, Jiequn AU - Huang J AD - Department of ICU, Shunde Hospital, Southern Medical University, Foshan Guangdong, China. FAU - Liu, Changzhi AU - Liu C FAU - Zhu, Ruiqiu AU - Zhu R FAU - Su, Yongpeng AU - Su Y FAU - Lin, Jingcheng AU - Lin J FAU - Lu, Jianhai AU - Lu J FAU - Wen, Shuchao AU - Wen S FAU - Zuo, Liuer AU - Zuo L LA - eng PT - Case Reports PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Glucocorticoids) RN - Amyopathic dermatomyositis SB - AIM SB - IM MH - Combined Modality Therapy MH - Dermatomyositis/*complications/therapy MH - Extracorporeal Membrane Oxygenation/*methods MH - Glucocorticoids/therapeutic use MH - Humans MH - Lung Diseases, Interstitial/etiology/*therapy MH - Male MH - Mediastinal Emphysema/etiology/therapy MH - Middle Aged MH - Plasmapheresis/*methods MH - Pneumothorax/etiology/therapy EDAT- 2018/06/01 06:00 MHDA- 2018/06/13 06:00 CRDT- 2018/06/01 06:00 PHST- 2018/06/01 06:00 [entrez] PHST- 2018/06/01 06:00 [pubmed] PHST- 2018/06/13 06:00 [medline] AID - 10.1097/MD.0000000000010946 [doi] AID - 00005792-201806010-00066 [pii] PST - ppublish SO - Medicine (Baltimore). 2018 Jun;97(22):e10946. doi: 10.1097/MD.0000000000010946.