{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:16:18Z","timestamp":1781716578395,"version":"3.54.5"},"reference-count":8,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["106680"],"award-info":[{"award-number":["106680"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>Anti-Melanoma Differentiation-Associated gene 5 (Anti-MDA-5) dermatomyositis is a rare subtype of inflammatory myopathy characterized by unique skin lesions, rapidly progressive interstitial lung disease, and skeletal muscle inflammation. It has a high mortality rate in the absence of early treatment. However, diagnosis of this entity is challenging in a country like Nepal because of various constraints such as lack of expert rheumatologists and resource limitations. Here we describe a case of one patient who had presented to us with generalized weakness, cough and shortness of breath who was finally diagnosed as anti-MDA-5 dermatomyositis. He responded to combination of immunosuppressives and is currently doing well. This case highlights the diagnostic and therapeutic challenges in managing such cases in a resource-limited setting.<\/ns4:p>","DOI":"10.12688\/wellcomeopenres.18728.1","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T10:17:15Z","timestamp":1672913835000},"page":"5","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Anti-MDA-5 dermatomyositis in a resource-limited setting"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6946-1847","authenticated-orcid":false,"given":"Ujjwol","family":"Risal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suravi","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-3301","authenticated-orcid":false,"given":"Raju","family":"Pangeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakshya","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmagat","family":"Bhattarai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-3425","authenticated-orcid":false,"given":"Sudeep","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-2743","authenticated-orcid":false,"given":"Buddha","family":"Basnyat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"1021-36","DOI":"10.1007\/s00296-021-04819-1","article-title":"Understanding and managing anti-MDA 5 dermatomyositis, including potential COVID-19 mimicry.","volume":"41","author":"P Mehta","year":"2021","journal-title":"Rheumatol Int."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"773352","DOI":"10.3389\/fimmu.2021.773352","article-title":"Dermatomyositis with Anti-MDA5 antibodies: bioclinical features, pathogenesis and emerging therapies.","volume":"12","author":"A Nombel","year":"2021","journal-title":"Front Immunol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"e70-8","DOI":"10.1212\/WNL.0000000000009727","article-title":"Different phenotypes in dermatomyositis associated with anti-MDA5 antibody: study of 121 cases.","volume":"95","author":"Y Allenbach","year":"2020","journal-title":"Neurology."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"637-42","DOI":"10.1073\/pnas.022637199","article-title":"mda-5: An interferon-inducible putative RNA helicase with double-stranded RNA-dependent ATPase activity and melanoma growth-suppressive properties.","volume":"99","author":"D Kang","year":"2002","journal-title":"Proc Natl Acad Sci U S A."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"48-55","DOI":"10.1016\/j.jaut.2019.04.001","article-title":"Frequency, mutual exclusivity and clinical associations of myositis autoantibodies in a combined European cohort of idiopathic inflammatory myopathy patients.","volume":"101","author":"Z Betteridge","year":"2019","journal-title":"J Autoimmun."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"e0154285","DOI":"10.1371\/journal.pone.0154285","article-title":"Clinical utility of an enzyme-linked immunosorbent assay for detecting anti-melanoma differentiation-associated gene 5 autoantibodies.","volume":"11","author":"S Sato","year":"2016","journal-title":"PLoS One."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"776-790","DOI":"10.1016\/j.semarthrit.2020.03.007","article-title":"Recommendations for the treatment of anti-melanoma differentiation-associated gene 5-positive dermatomyositis-associated rapidly progressive interstitial lung disease.","volume":"50","author":"F Romero-Bueno","year":"2020","journal-title":"Semin Arthritis Rheum."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"133-40","DOI":"10.1080\/14397595.2017.1318468","article-title":"Evaluation of clinical prognostic factors for interstitial pneumonia in anti-MDA5 antibody-positive dermatomyositis patients.","volume":"28","author":"Y Fujiki","year":"2018","journal-title":"Mod Rheumatol."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T07:45:12Z","timestamp":1685087112000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,5]]},"references-count":8,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.18728.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r57294","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r56302","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r57292","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r57294","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r57292","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.20766.r56302","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,5]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1#article-reports","order":0,"name":"referee-status","label":"Referee 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Fiorentino, Stanford University, Stanford, California, 25 May 2023, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1#referee-response-57294","order":1,"name":"referee-response-57294","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.20766.r57292, Liza Rajasekhar, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 26 May 2023, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-5\/v1#referee-response-57292","order":2,"name":"referee-response-57292","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome [106680]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}