Direct hemoperfusion using a polymyxin B-immobilized fiber column (PMX-DHP), which can reduce endotoxin levels and inflammatory chemical mediators such as cytokines,[27] has demonstrated effectiveness for RPILD with CADM.[21,28] In previous cases, PE was also effective for severe ILD with antiaminoacyl tRNA synthetase antibody-positive patients who were refractory to the standard treatments.[20,29] Another case report showed the effectiveness of hemoperfusion with both PMX-DHP and PE for RPILD with anti-MDA5 Ab-positive CADM patients.[30]. This evidence concerns the gene IFIH1 and clinically amyopathic dermatomyositis.