Kee Kwong-Ming, Wang Jing-Houng, Lee Chuan-Mo, Changchien Chi-Sin, Eng Hock-Liew
Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung.
Chang Gung Med J. 2004 Nov;27(11):834-9.
Dermatomyositis is a rare and idiopathic inflammatory myopathy with characteristic cutaneous manifestations. In recent years, some researchers have showed the cause of dermatomyositis might be due to an autoimmune response induced by viral infections. However, chronic hepatitis C virus (HCV) infection associated with dermatomyositis is very rare. In this report, we present a patient with dematomyositis with abnormal liver function test results and elevated alfa-fetoprotein level. After excluding multiple viral infections known to cause myositis, the case was proven to be chronic hepatitis C by positive HCV-RNA in the serum. Abdominal computed tomography showed a liver tumor on the right lobe and needle biopsy proved it to be hepatocellular carcinoma. Chronic hepatitis C or hepatocellular carcinoma might cause dermatomyositis by inducing the formation of autoantibodies. Chronic hepatitis C or hepatocellular carcinoma should be considered in patients of dermatomyositis if no other cause is found.
皮肌炎是一种罕见的特发性炎性肌病,伴有特征性皮肤表现。近年来,一些研究人员表明,皮肌炎的病因可能是病毒感染诱导的自身免疫反应。然而,与皮肌炎相关的慢性丙型肝炎病毒(HCV)感染非常罕见。在本报告中,我们介绍了一名肝功能检查结果异常且甲胎蛋白水平升高的皮肌炎患者。在排除已知可引起肌炎的多种病毒感染后,血清中HCV-RNA阳性证实该病例为慢性丙型肝炎。腹部计算机断层扫描显示右叶有肝脏肿瘤,针吸活检证实为肝细胞癌。慢性丙型肝炎或肝细胞癌可能通过诱导自身抗体形成而导致皮肌炎。如果未发现其他病因,皮肌炎患者应考虑慢性丙型肝炎或肝细胞癌。