Department of Neurology, Mitsui Memorial Hospital, Tokyo, Japan.
Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan.
Int J Rheum Dis. 2023 Dec;26(12):2572-2575. doi: 10.1111/1756-185X.14755. Epub 2023 Jun 7.
Gastrointestinal manifestations are a very rare complication of dermatomyositis (DM) and are much less frequent in adult cases than in juvenile cases. Only a few previous papers have reported adult patients who had DM with anti-nuclear matrix protein 2 (anti-NXP2) antibodies and who developed gastrointestinal ulcers. Herein, we report a similar case of a 50-year-old man who had DM with anti-NXP2 antibodies followed by relapsing multiple gastrointestinal ulcers. Even after the administration of prednisolone, his muscle weakness and myalgia deteriorated and gastrointestinal ulcers relapsed. In contrast, intravenous immunoglobulin and azathioprine improved his muscle weakness and gastrointestinal ulcers. Based on the parallel disease activity of the muscular and gastrointestinal symptoms, we considered that his gastrointestinal ulcers were a complication of DM with anti-NXP2 antibodies. We also propose that early intensive immunosuppressive therapy would be required for the muscular and gastrointestinal symptoms in DM with anti-NXP2 antibodies.
胃肠道表现是皮肌炎（DM）非常罕见的并发症，在成年病例中比在青少年病例中少见得多。只有少数先前的论文报道了患有抗核基质蛋白 2（抗-NXP2）抗体的皮肌炎成年患者，并发生了胃肠道溃疡。在此，我们报告了一例类似的病例，一名 50 岁男性患有抗-NXP2 抗体的皮肌炎，随后出现复发性多发性胃肠道溃疡。即使给予泼尼松龙治疗，他的肌肉无力和肌痛仍在恶化，胃肠道溃疡也在复发。相比之下，静脉注射免疫球蛋白和硫唑嘌呤改善了他的肌肉无力和胃肠道溃疡。基于肌肉和胃肠道症状的平行疾病活动，我们认为他的胃肠道溃疡是抗-NXP2 抗体皮肌炎的并发症。我们还建议，对于抗-NXP2 抗体皮肌炎的肌肉和胃肠道症状，需要早期强化免疫抑制治疗。
