Izumi Yasumori, Kojima Hiroshi, Koga Yasushi, Yokota Kazuaki, Mori Hideki, Ohno Tadayoshi, Miyashita Taiichiro, Ito Masahiro, Motomura Masakatsu, Mine Masanobu, Ezaki Hironori, Jiuchi Yuka, Niino Daisuke, Ohshima Kouichi, Migita Kiyoshi
Department of General Internal Medicine and Rheumatology, NHO National Nagasaki Medical Center, Japan.
Intern Med. 2011;50(17):1849-53. doi: 10.2169/internalmedicine.50.5013. Epub 2011 Sep 1.
A 56-year-old HTLV-I-positive woman, initially diagnosed as having Sjögren's syndrome, presented with muscle weakness, myalgia, face erythema and leg edema. Based on the presence of various autoantibodies, the diagnosis of overlap syndrome (dermatomyositis/Sjögren's syndrome) was made. Treatment with high-dose corticosteroid plus cyclosporine improved her symptoms. However, three months after the start of these treatments, exacerbation of myositis occurred. A muscle biopsy revealed prominent perivascular accumulation of mononuclear cells with perifascicular atrophy, which were consistent with dermatomyositis. Tacrolimus, which was substituted for cyclosporine led to marked improvement of the myositis symptoms.
一名56岁的HTLV-I阳性女性，最初被诊断为干燥综合征，出现肌肉无力、肌痛、面部红斑和腿部水肿。基于多种自身抗体的存在，诊断为重叠综合征（皮肌炎/干燥综合征）。大剂量皮质类固醇加环孢素治疗改善了她的症状。然而，这些治疗开始三个月后，肌炎加重。肌肉活检显示血管周围有明显的单核细胞聚集和束周萎缩，符合皮肌炎表现。用他克莫司替代环孢素后，肌炎症状明显改善。
