Ling Yanyan, Hu Huaiqiang, Xu Xiangyan, Feng Jianli, Li Mingzhe, Li Huan, Cheng Ming, Wang Xiaoling
Department of Neurology, Shandong Second Provincial General Hospital, Jinan, China.
Department of Neurology, The 960th Hospital of Joint Logistics Force, PLA, Jinan, China.
Front Oncol. 2024 Aug 7;14:1416083. doi: 10.3389/fonc.2024.1416083. eCollection 2024.
Juvenile dermatomyositis (JDM) is a rare autoimmune myopathy whose main clinical manifestations include a characteristic rash, symmetrical proximal muscle weakness, and elevated muscle enzymes. While approximately one-third of adult patients with dermatomyositis (DM) develop malignancies, typically within a year of diagnosis, this phenomenon is not commonly observed in patients with JDM. In this study, we present a rare case of both JDM and Hodgkin's lymphoma (HL) diagnosed in an adolescent female patient.
A 14-year-old girl with proximal muscle weakness and myalgia for 8 weeks was admitted to the hospital and ultimately received a diagnosis of DM. A thorough physical examination revealed enlarged lymph nodes on both sides of the cervical, and a lymph node biopsy was performed to diagnose HL. After she underwent radiotherapy and chemotherapy, her symptoms of both HL and DM were alleviated.
The phenomenon of JDM as a paraneoplastic syndrome associated with HL is very rare. Thus, routine cancer screening for DM in adolescents is currently not recommended. The diagnosis of JDM requires a detailed physical examination, and further tumor screening is necessary for patients with unusual physical findings, such as atypical rashes, enlarged lymph nodes, and enlargement of the spleen and/or liver. Even if no malignancy is detected when JDM is diagnosed, long-term follow-up is necessary.
青少年皮肌炎（JDM）是一种罕见的自身免疫性肌病，其主要临床表现包括特征性皮疹、对称性近端肌无力和肌酶升高。虽然约三分之一的成年皮肌炎（DM）患者会发生恶性肿瘤，通常在诊断后一年内，但这种现象在JDM患者中并不常见。在本研究中，我们报告了一例在青少年女性患者中同时诊断出JDM和霍奇金淋巴瘤（HL）的罕见病例。
一名14岁女孩因近端肌无力和肌痛8周入院，最终被诊断为DM。全面体格检查发现双侧颈部淋巴结肿大，遂进行淋巴结活检以诊断HL。她接受放疗和化疗后，HL和DM的症状均得到缓解。
JDM作为与HL相关的副肿瘤综合征的现象非常罕见。因此，目前不建议对青少年DM患者进行常规癌症筛查。JDM的诊断需要详细的体格检查，对于有异常体格检查结果的患者，如非典型皮疹、淋巴结肿大以及脾脏和/或肝脏肿大，有必要进一步进行肿瘤筛查。即使在诊断JDM时未检测到恶性肿瘤，也需要进行长期随访。
