Matsuoka Naoki, Asano Tomoyuki, Sato Shuzo, Sasajima Tomomi, Fujita Yuya, Temmoku Jumpei, Yashiro Furuya Makiko, Matsumoto Haruki, Suzuki Eiji, Kobayashi Hiroko, Watanabe Hiroshi, Migita Kiyoshi
Department of Rheumatology, Fukushima Medical University School of Medicine.
Department of Rheumatology, Fukushima Rosai Hospital.
Fukushima J Med Sci. 2020 Jan 9;65(3):140-145. doi: 10.5387/fms.2019-09. Epub 2019 Dec 11.
We report a patient with dermatomyositis (DM) complicated with progressive pleural effusion and ascites. A 40-year-old woman was hospitalized in our department because of severe myalgia and dysphagia, complicated with pleural effusion and massive ascites. Elevated muscle enzymes, Gottron's papules, and electromyography (EMG) confirmed the diagnosis of DM. Combined immunosuppressive treatment consisting of intravenous immunoglobulin (IV-IG), intravenous-cyclophosphamide (IV-CY) and tacrolimus resolved her myopathy and dysphagia as well as pleural effusion and massive ascites. Her clinical course and the absence of other factors that cause pleural effusion and ascites suggest that these symptoms were related to the pathophysiology of DM.
我们报告了一名皮肌炎（DM）合并进行性胸腔积液和腹水的患者。一名40岁女性因严重肌痛和吞咽困难并伴有胸腔积液和大量腹水入住我科。肌酶升高、Gottron丘疹及肌电图（EMG）确诊为DM。由静脉注射免疫球蛋白（IV-IG）、静脉注射环磷酰胺（IV-CY）和他克莫司组成的联合免疫抑制治疗缓解了她的肌病、吞咽困难以及胸腔积液和大量腹水。她的临床病程以及不存在其他导致胸腔积液和腹水的因素表明，这些症状与DM的病理生理有关。
