Ghosh Ritwik, Dubey Souvik, Chatterjee Subhankar, Biswas Rakesh
Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital, Kolkata, West Bengal, India.
BMJ Case Rep. 2020 Feb 28;13(2):e232770. doi: 10.1136/bcr-2019-232770.
Dermatomyositis (DM) belongs to the spectrum of inflammatory myopathies which are a heterogeneous group of acquired disorders in which dysregulated immune system is thought to play a major pathologic role. Patients with DM generally present with characteristic skin manifestations with or without muscle weakness and pain. Although subclinical myocardial involvement in DM is well reported in literature, heart failure (HF) as its principal manifestation is extremely rare. Recognition of DM, a known paraneoplastic syndrome, should prompt clinicians to search for underlying malignancy. While gynaecological malignancies are common in association with DM, cervical cancer has rarely been heard of as an aetiology of paraneoplastic DM. We are reporting a case of DM in a postmenopausal woman presenting with advanced decompensated congestive HF with hidden squamous cell carcinoma of cervix.
皮肌炎(DM)属于炎性肌病范畴,炎性肌病是一组异质性的后天性疾病,其中免疫系统失调被认为起主要病理作用。DM患者通常表现为特征性皮肤表现,伴有或不伴有肌肉无力和疼痛。尽管文献中已充分报道DM存在亚临床心肌受累情况,但其以心力衰竭(HF)为主要表现极为罕见。认识到DM这一已知的副肿瘤综合征,应促使临床医生寻找潜在的恶性肿瘤。虽然妇科恶性肿瘤常与DM相关,但很少听说宫颈癌是副肿瘤性DM的病因。我们报告一例绝经后女性DM病例,该患者表现为晚期失代偿性充血性HF,同时伴有隐匿性宫颈鳞状细胞癌。