Two months ago, Ms. Lanh sought medical attention but the cause was not found, and medication provided no improvement. With her condition worsening, she came to Tam Anh General Hospital, TP HCM, where she was prescribed oxygen therapy, a CT scan, and various blood and antibody tests. Dr. Nguyen Thanh Thuy, a Master of Science and First-Degree Specialist in General Internal Medicine, diagnosed her with rapidly progressive interstitial lung disease linked to MDA5 autoimmune dermatomyositis.

Dr. Thuy explained that in patients with MDA5 dermatomyositis, the immune system produces autoantibodies that target the MDA5 protein, a component involved in the body's antiviral response. When disordered, the immune system triggers an inflammatory response, damaging the lungs, causing pulmonary fibrosis, and reducing oxygen exchange, which leads to shortness of breath. The disease can also affect skeletal muscles, skin, peripheral blood vessels, and the heart.

The treatment team combined two high-dose immunosuppressants with cyclophosphamide (Endoxan), a chemotherapy drug commonly used in cancer treatment, for Ms. Lanh. According to Dr. Thuy, this protocol is applied to severe autoimmune diseases to control excessive immune responses.

The patient received 6 cycles of Endoxan over 6 months, combined with other immunosuppressants and gradually reduced doses. The goal was to control the autoimmune response causing lung parenchymal damage, prevent rapid disease progression, and limit irreversible changes.

After 3 months, Ms. Lanh could walk again, and her health is now stable, with no more shortness of breath.

Dr. Thuy explains Ms. Lanh's health condition during a follow-up visit. *Photo: Tam Anh General Hospital*

Dr. Thuy stated that MDA5 dermatomyositis is one of the autoimmune diseases with a high risk of causing rapidly progressive interstitial pneumonia. Lung damage can occur even when external skin manifestations are atypical. The disease has subtle initial manifestations, which may include skin lesions or mild muscle fatigue.

Patients should seek medical attention if they experience persistent abnormal signs such as unexplained red rashes, skin papules, muscle weakness, fatigue, or shortness of breath. Individuals with underlying conditions like diabetes, high blood pressure, or chronic kidney failure also need to monitor their health and have regular follow-up appointments as advised by their doctor.

Nhat Thanh

*Patient's name has been changed