Mamyrova Gulnara, Kleiner David E, James-Newton Laura, Shaham Bracha, Miller Frederick W, Rider Lisa G
Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, Bethesda, Maryland 20892-1301, USA.
Arthritis Rheum. 2007 Jun 15;57(5):881-4. doi: 10.1002/art.22782.
We present the clinical and pathologic features of two patients with juvenile dermatomyositis (DM) with severe gastrointestinal ulceration or perforation who required surgery. Abdominal pain which is persistent, progressive or severe, even in patients with improving or mildly active juvenile DM, should be carefully evaluated. The absence of occult blood in the stool and normal radiographs do not exclude these potentially serious complications. Chronic endarteropathy, not an acute vasculopathy previously reported, is the pathology associated with the ischemic ulceration in these patients. The current approach to treatment of juvenile DM with immunosuppressive agents may have contributed to delay in the onset of these gastrointestinal manifestations and to their pathologic features.
我们报告了两例患有严重胃肠道溃疡或穿孔并需要手术治疗的青少年皮肌炎（DM）患者的临床和病理特征。即使在青少年DM病情改善或轻度活动的患者中，持续、进行性或严重的腹痛也应仔细评估。大便潜血阴性和X线片正常并不能排除这些潜在的严重并发症。慢性动脉内膜病而非先前报道的急性血管病，是与这些患者缺血性溃疡相关的病理改变。目前使用免疫抑制剂治疗青少年DM的方法可能导致了这些胃肠道表现的发病延迟及其病理特征的出现。
