Kilani Badreddine, Amari Lamia, Houmane Habib, Ben Châabane Taoufik
Service des Maladies Infectieuses, Hôpital La Rabta, Tunis.
Tunis Med. 2005 Apr;83(4):230-2.
Systemic lupus erythematosus (SLE) associated with dermatopolymyositis (DM). This association is rare. Diagnosis may be difficult because of their common clinical findings. We report here a case. A 22-year-old man was admitted for arthritis with fever, diffuse myalgia and periorbital skin heliotrope rash. Electromyogram and muscular biopsy were suggestive of DM. The patient was treated with oral prednisone. Two months and a half later, he was admitted for impure nephrotic syndrome in relation with diffuse proliferative glomerulonephritis. Antibodies against native double-stranded- DNA were positive, and normal skin biopsy showed immune complex deposit on dermo-epidermic junction, suggestive of SLE. The patient was treated with high doses of prednisone and 6 monthly intravenous pulses of cyclophosphamide. Skin lesions and nephrotic syndrome improved. Presently, the patient remains asymptomatic. While being of different pathogenesis, SLE and DM may coexist in the same patient.
系统性红斑狼疮（SLE）合并皮肌炎（DM）。这种关联很罕见。由于它们常见的临床表现，诊断可能会很困难。我们在此报告一例病例。一名22岁男性因关节炎伴发热、弥漫性肌痛和眶周皮肤紫罗兰色皮疹入院。肌电图和肌肉活检提示为皮肌炎。该患者接受口服泼尼松治疗。两个半月后，他因与弥漫性增殖性肾小球肾炎相关的不纯肾病综合征入院。抗天然双链DNA抗体呈阳性，正常皮肤活检显示免疫复合物沉积于真皮-表皮交界处，提示为系统性红斑狼疮。该患者接受了大剂量泼尼松和每月6次静脉注射环磷酰胺治疗。皮肤病变和肾病综合征有所改善。目前，该患者仍无症状。虽然系统性红斑狼疮和皮肌炎发病机制不同，但可能在同一患者中共存。
