Constantin Tamás, Ponyi Andrea, Garami Miklós, Gergely Lajos, Fekete György, Dankó Katalin
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. sz. Gyermekgyógyászati Klinika, Budapest.
Orv Hetil. 2003 Jun 22;144(25):1245-50.
Dermatomyositis, belonging to the group of the idiopathic inflammatory myopathies, is characterized by bimodal pattern of age-specific incidence of rates, with peaks in age group from 5 to 14 years (juvenile dermatomyositis) and in age group from 45 to 64 years (adult dermatomyositis).
Is to evaluate the clinical characteristics of 12 patients with juvenile dermatomyositis followed by the 3rd Department of Internal Medicine, University of Debrecen and the 2nd Department of Pediatrics, Semmelweis University, Budapest.
The authors analyzed the medical records of the patients with juvenile and adult form of dermatomyositis retrospectively.
All of the children had symmetrical weakness of the proximal muscles. The most frequent cutaneous features were facial erythema and Gottron papules (11/12). The extramuscular manifestations were also assessed. 7 children had arthralgia. There were observed pulmonary fibrosis, Raynaud-syndrome, dysphagia and sicca-syndrome in the same patient, whose disease is overlapped with progressive systemic sclerosis. In view of the clinical course, the authors found that prevalence of polycyclic (relapsing-remitting) and monophasic subtypes of the disease were similar (6/12 and 5/12). Finally, all of the patients achieved remission, however, 2 patients have to take low-dose corticosteroid therapy permanently to maintain remission. One patient's cutaneous symptoms proved to be persistent and in further 2 cases, regression of the calcinosis is slow, but continuous.
The authors compare their data of juvenile patients with the data of the relevant literature and to their experience with the management of adult DM patients. It seems to be reasonable to treat the patients in centres.
皮肌炎属于特发性炎性肌病,其发病率具有双峰模式的年龄特异性,在5至14岁年龄组(幼年皮肌炎)和45至64岁年龄组(成人皮肌炎)出现发病高峰。
是评估德布勒森大学内科第三科室及布达佩斯塞梅尔维什大学儿科第二科室所诊治的12例幼年皮肌炎患者的临床特征。
作者回顾性分析了幼年和成人形式皮肌炎患者的病历。
所有儿童均有近端肌肉对称性无力。最常见的皮肤表现为面部红斑和Gottron丘疹(11/12)。还评估了肌肉外表现。7名儿童有关节痛。在一名疾病与进行性系统性硬化症重叠的患者中观察到肺纤维化、雷诺综合征、吞咽困难和干燥综合征。从临床病程来看,作者发现该疾病的多相(复发-缓解型)和单相亚型的患病率相似(6/12和5/12)。最后,所有患者均实现缓解,然而,2名患者必须长期接受低剂量皮质类固醇治疗以维持缓解。一名患者的皮肤症状持续存在,另外2例患者的钙质沉着消退缓慢,但仍在持续。
作者将其幼年患者的数据与相关文献数据以及他们治疗成年皮肌炎患者的经验进行了比较。在中心治疗这些患者似乎是合理的。