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August 15, 2026CureusOpen Access

Antinuclear Antibody (ANA)‑Negative, Anti-melanoma Differentiation-Associated Gene 5 (MDA5)‑Positive Dermatomyositis Presenting as Rapidly Progressive Interstitial Lung Disease: A Case Report

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To describe a case of anti-MDA5-positive dermatomyositis presenting as rapidly progressive interstitial lung disease in a patient with negative standard antinuclear antibody screening.
Clinical, radiographic, and immunological evaluation of a 43-year-old woman presenting with severe post-surgical hypoxic respiratory failure mimicking acute lung injury.
Diagnostic workup included bronchoscopy, high-resolution chest imaging, routine autoimmune serologies, and extended myositis-specific antibody profiling.
Standard antinuclear antibody and infectious panels were negative, but an extended panel confirmed anti-MDA5 positivity alongside diffuse bilateral ground-glass opacities and fibrosis.
Combination immunosuppressive treatment with rituximab, mycophenolate mofetil, and intravenous immunoglobulin resulted in clinical stabilization and hospital discharge on 4 L/min supplemental oxygen.

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Implication

Case report reveals anti-MDA5 dermatomyositis causing severe lung disease despite negative antinuclear antibodies, highlighting the need for specialized myositis testing in acute respiratory failure.

Cite This Study

Nish et al. (2026) studied this question.

synapsesocial.com/papers/6a80199875c2e31742c858cc https://doi.org/10.7759/cureus.114432

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Implication

Case report reveals anti-MDA5 dermatomyositis causing severe lung disease despite negative antinuclear antibodies, highlighting the need for specialized myositis testing in acute respiratory failure.

Antinuclear Antibody (ANA)‑Negative, Anti-melanoma Differentiation-Associated Gene 5 (MDA5)‑Positive Dermatomyositis Presenting as Rapidly Progressive Interstitial Lung Disease: A Case Report

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Discussion

Implication

Cite This Study

Antinuclear Antibody (ANA)‑Negative, Anti-melanoma Differentiation-Associated Gene 5 (MDA5)‑Positive Dermatomyositis Presenting as Rapidly Progressive Interstitial Lung Disease: A Case Report

Key Points

Discussion

Implication

Cite This Study