Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia

Case Reports in Critical Care
Tomohiro ShojiTakahiko Kamibayashi

Abstract

A 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse therapy for suspected interstitial pneumonia, the patient's condition worsened. Respiratory distress was slightly alleviated after the initiation of high-flow nasal cannula (HFNC) oxygen therapy (40 L/min, FiO2 40%). We suspected clinically amyopathic dermatomyositis (CADM) complicating rapidly progressive refractory interstitial pneumonia. In order to save the life of the patient, the use of combination therapy with immunosuppressants was necessary. The patient underwent emergency cesarean section and was immediately treated with immunosuppressants while continuing HFNC oxygen therapy. The neonate was treated in the neonatal intensive care unit. The patient's condition improved after 7 days of hospitalization; by this time, she was positive for myositis-specific autoantibodies and was diagnosed with interstitial pneumonia preceding dermatomyositis. This condition can be potentially fatal within a few months of onset and therefore r...Continue Reading

References

Mar 1, 1989·Obstetrical & Gynecological Survey·B A RosenzweigM Phillippe
May 8, 2003·Journal of the American Academy of Dermatology·Richard D Sontheimer, Sachiko Miyagawa
Oct 15, 2005·Current Opinion in Rheumatology·Maryam Fathi, Ingrid E Lundberg
May 20, 2015·The New England Journal of Medicine·Jean-Pierre FratUNKNOWN REVA Network
Oct 3, 2015·Medicina intensiva·J R MasclansO Roca
Feb 18, 2016·Respiratory Investigation·Yukihiro HorioKoichiro Asano

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Methods Mentioned

BETA
cesarean section
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