• Xu Qin, Xiaobo Chen, Yu Deng, Ying-Ying Gu, Lijun Zeng, Shunkai Huang, Lihong Sun, and Shiyue Li.
• Department of Pediatric Pulmonology, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangdong, China.
• Chest. 2021 Jul 1; 160 (1): e45-e50.

Case PresentationA 12-year-old girl presented with shortness of breath with exercise for 2 weeks. Her oxygen saturation was 85% during exercise. Birth and family histories were unremarkable. The girl was healthy until 7.1 years of age, when she suffered a "pneumonia" with fever, dyspnea, and hypoxemia, which diminished after a 19-day treatment with antibiotics and methylprednisolone. These symptoms relapsed 8 months later, and she was diagnosed with rapidly progressive interstitial lung disease (ILD) and a Mycoplasma pneumoniae infection. At that time, her symptoms failed to respond to a course of antibiotic therapy but resolved with IV methylprednisolone at 2.7 mg/kg/day. She remained on a tapering dose of methylprednisolone plus methotrexate for the next 18 months until withdrawal of these medications because of return of almost normal lung imaging. She had never had myalgia, muscle weakness, arthritis, rashes, mechanic's hands, Raynaud's phenomenon, dry mouth, or dry eyes.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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