• Internal medicine · Dec 2024

    Review Case Reports

    Tension Pneumomediastinum in Anti-MDA5 Antibody-positive Dermatomyositis-associated Interstitial Lung Disease: A Case Report and Literature Review.

    • Hiroko Okabayashi, Seiya Nakashima, Kosuke Fujino, Miyu Imai, Shohei Hamada, Aiko Masunaga, Hidenori Ichiyasu, Makoto Suzuki, and Takuro Sakagami.
    • Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Japan.
    • Intern. Med. 2024 Dec 1; 63 (23): 322132263221-3226.

    AbstractAnti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM)-associated interstitial lung disease (ILD) can sometimes be complicated by pneumomediastinum, although tension pneumomediastinum is extremely rare. We herein report a case of anti-MDA5 antibody-positive DM-ILD that worsened subcutaneous and mediastinal emphysema during treatment. Hypotension and worsening respiratory failure were observed on day 20 of treatment. Mediastinal drainage under video-assisted thoracoscopic surgery promptly improved the patient's circulatory and respiratory status. Tension pneumomediastinum is a rare complication; however, it is a serious condition that may lead to hypotension or cardiac arrest and requires a prompt diagnosis and treatment.

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