Objectives Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM) is characterised by rapidly progressive interstitial lung disease and has a poor prognosis. We aimed to investigate whether anti-MDA5 antibody titres and cytokine levels predict clinical course, and evaluate changes in both parameters before and after diagnosis. Methods This was a retrospective, single-centre study in 38 patients with anti-MDA5 antibody-positive DM. We compared clinical characteristics and laboratory data at diagnosis between patients in the treatment response (n = 23) and non-response (n = 15) groups, and between those in the relapse (n = 5) and non-relapse (n = 24) groups. We also measured serum anti-MDA5 antibody titres and cytokine levels before and after diagnosis. Results The non-response group was older, had a higher ground-glass opacity score, lower PaO2/FiO2, higher C-reactive protein (CRP) level, and higher anti-MDA5 antibody titre than the response group. No cytokines significantly differed between groups at diagnosis. The relapse group had a significantly higher anti-MDA5 antibody titre than the non-relapse group. In the survivor group, the anti-MDA5 antibody titre and levels of interferon (IFN)-α, IFN-γ, monocyte chemotactic protein-1 (MCP-1), interleukin (IL)-6, IL-33, CRP, and ferritin were significantly lower 6 months post-treatment than at diagnosis. Macrophage-associated cytokines such as IL-6, IL-8, IL-18, and MCP-1 increased after anti-MDA5 antibody positivity in three patients who were anti-MDA5 antibody-positive before diagnosis. Conclusion The anti-MDA5 antibody titre at diagnosis may predict the clinical course. Levels of macrophage-associated cytokines significantly declined at 6 months post-treatment, and they may have increased after anti-MDA5 antibody titre positivity.

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Background In patients with systemic lupus erythematosus (SLE), infections, especially bacteremia, can occur throughout the course of the disease and are often fatal. We evaluated the characteristics of patients with bacteremia and SLE. Methods In this retrospective single-center observational study, we analyzed bacteremia in 65 patients with SLE. We compared the group that survived to the group that died. To compare demographic and clinical characteristics between groups, the Mann–Whitney U test was used for non-normally distributed variables. Categorical variables were compared using Fisher’s exact test. Results The median observation period was 39 (interquartile range: 6–74) months. The median age was 54 (43–64) years. Patients consisted of six males and 59 females. In 49 cases, the patient survived. In 16 cases, the patient died. The dead group was older, with lower Glasgow Coma Scale scores, higher sequential organ failure assessment (SOFA) scores, and lower fibrinogen levels. Conclusion When physicians encounter patients with suspected bacteremia, they should pay attention to the consciousness assessment and SOFA score, and be aware of infections caused by common microorganisms and opportunistic infections.

In response to the coronavirus disease 2019 (COVID-19) pandemic, the COVID-19 vaccine was rapidly developed, and the effectiveness of the vaccine has been established. However, various adverse effects have been reported, including development of autoimmune diseases. We report a case of new-onset polyarteritis nodosa (PAN) in a 32-year-old male following COVID-19 vaccination. The patient developed limb pain, fever, pulmonary embolism, and multiple subcutaneous nodules and haematomas. Skin biopsy revealed necrotising inflammation accompanied by fibrinoid necrosis and high inflammatory cell infiltration in the walls of medium to small arteries. The symptoms resolved following corticosteroid treatment. Although it is difficult to prove a relationship between the vaccine and PAN, similar cases have been reported, and further reports and analyses are therefore necessary.

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