Yamagishi Masashi, Tajima Shunji, Suetake Aki, Kawakami Hidenori, Watanabe Takeo, Kuriyama Hideyuki, Takada Toshinori, Suzuki Eiichi, Gejyo Fumitake
Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Rheumatol Int. 2009 Sep;29(11):1363-6. doi: 10.1007/s00296-008-0821-3. Epub 2008 Dec 17.
A 64-year-old Japanese female, diagnosed as dermatomyositis with acute interstitial pneumonia, complained of acute abdominal pain. Computed tomography of the abdomen showed hematoma in the right retroperitoneum and left rectus-sheath. Angiogram showed multiple small aneurysms on left iliolumbar artery and a horizontal linear flush, suggesting active bleeding foci in the muscles. Although arterial embolization therapy was effective for hemostatic treatment, she died of thrombotic thrombocytopenic purpura and multiple organ failure without respiratory insufficiency. Other causes of microaneurysm, such as systemic vasculitides or infectious diseases, were excluded. We considered that this is the first case report of dermatomyositis with hemorrhagic myositis associated with small aneurysms.
一名64岁的日本女性，被诊断为皮肌炎合并急性间质性肺炎，主诉急性腹痛。腹部计算机断层扫描显示右腹膜后和左腹直肌鞘内有血肿。血管造影显示左髂腰动脉有多个小动脉瘤以及一条水平线性充盈，提示肌肉中有活动性出血灶。尽管动脉栓塞治疗对止血有效，但她死于血栓性血小板减少性紫癜和多器官功能衰竭，未出现呼吸功能不全。排除了其他导致微动脉瘤的原因，如系统性血管炎或传染病。我们认为这是首例皮肌炎合并出血性肌炎伴小动脉瘤的病例报告。
