Arimura Yasuji, Ohi Takekazu, Shiomi Kazutaka, Yamashita Atsushi, Asada Yujiro
Division of Neurology, Department of Internal Medicine, Miyazaki Medical College, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
No To Shinkei. 2003 Jul;55(7):599-604.
A 38-year-old man had suffered from general fatigue, mild weakness of proximal muscles, and dry cough in November, 2000. Serum levels of muscle enzymes were elevated. Computed tomography of the chest revealed reticular appearance in the bilateral dorsal lung areas. He did not show any improvement, therefore he was referred to our hospital in April, 2001. He was diagnosed as mild polymyositis with mild interstitial pneumonia. He was treated intravenously with methylprednisolone pulse therapy. During the pulse therapy serum level of creatine kinase was decreased, but he died because of acute pump failure of the heart. The cause of the heart failure could be an exacerbation of chronic myocarditis associated with polymyositis and it was confirmed by autopsy findings. When a patient with mild polymyositis complains of general fatigue, myocarditis should be carefully evaluated because of the high risk of death.
一名38岁男性于2000年11月出现全身乏力、近端肌肉轻度无力及干咳症状。血清肌酶水平升高。胸部计算机断层扫描显示双侧肺背侧区域呈网状外观。他的症状未见改善，因此于2001年4月转诊至我院。他被诊断为轻度多发性肌炎合并轻度间质性肺炎。给予甲泼尼龙静脉脉冲治疗。脉冲治疗期间肌酸激酶血清水平下降，但他因急性心脏泵衰竭死亡。心力衰竭的原因可能是与多发性肌炎相关的慢性心肌炎加重，尸检结果证实了这一点。当轻度多发性肌炎患者主诉全身乏力时，应仔细评估是否存在心肌炎，因为死亡风险较高。
