Nakayama Seiko, Fukushima Kiyoyasu, Ehara Naomi, Okuno Kazuhiro, Hayashi Tomayoshi, Mukae Hiroshi, Kitaichi Masanori, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki Prefecture Tarami Hospital.
Nihon Kokyuki Gakkai Zasshi. 2004 May;42(5):429-34.
A 53-year-old woman visited our hospital in July 2002 with complaints of skin eruptions on the face and extremities, dry cough and dyspnea. A diagnosis of amyopathic dermatomyositis (ADM) was made on the basis of characteristic skin lesions and skin biopsy findings with slight muscle symptoms and mild elevation of muscle enzymes. Interstitial shadows were observed in both lower lung fields on chest radiographs, and thoracoscopic lung biopsy specimens revealed a diffuse alveolar damage (DAD) pattern. After induction of chemotherapy with prednisolone (50 mg/day) and cyclosporin A (150 mg/day), the respiratory symptoms and interstitial shadows were gradually reduced. Although it is known that interstitial pneumonia has an acute course and poor prognosis in ADM, the present case responded well to the chemotherapy with prednisolone and cyclosporin A.
一名53岁女性于2002年7月因面部及四肢皮肤疹、干咳和呼吸困难前来我院就诊。基于特征性皮肤病变、皮肤活检结果、轻微肌肉症状及肌肉酶轻度升高,诊断为无肌病性皮肌炎(ADM)。胸部X线片显示双下肺野有间质性阴影,胸腔镜肺活检标本显示为弥漫性肺泡损伤(DAD)模式。在用泼尼松龙(50毫克/天)和环孢素A(150毫克/天)进行化疗诱导后,呼吸道症状和间质性阴影逐渐减轻。尽管已知间质性肺炎在ADM中病程急性且预后不良,但本例对泼尼松龙和环孢素A化疗反应良好。