Ozawa Y, Kurosaka D, Hashimoto N
Third Department of Internal Medicine, Jikei University School of Medicine.
Nihon Rinsho Meneki Gakkai Kaishi. 1995 Oct;18(5):552-8. doi: 10.2177/jsci.18.552.
An autopsy case of dermatomyositis with rapidly progressive interstitial pneumonia is reported. a 48-year-old woman was admitted because of facial edematous erythema and muscular weakness. A diagnosis of dermatomyositis was made because of typical erythema and myogenic pattern of EMG, although serum creatine kinase was within normal range. The chest X-ray film showed that interstitial pneumonia was complicated. She was treated with prednisolone of 60 mg/day. Although erythema and althralgia was improved remarkably, interstitial pneumonia was progressed unfavorably. Therefore pulse therapy with methylprednisolone was administered twice, but failed to respond. After that interstitial pneumonia was progressed rapidly, she was died of respiratory failure. The autopsy findings detected that a degeneration and necrosis of striated muscular fibers in whole body, that a mixed findings of usual interstitial pneumonia and diffuse alveolar damage in the lung. Vasculitis and fiblinous pleuritis was also found in the lung. Malignancy was not detected.
报告了一例伴有快速进展性间质性肺炎的皮肌炎尸检病例。一名48岁女性因面部水肿性红斑和肌肉无力入院。尽管血清肌酸激酶在正常范围内，但由于典型的红斑和肌电图的肌源性模式，诊断为皮肌炎。胸部X线片显示并发间质性肺炎。她接受了每日60毫克泼尼松龙的治疗。尽管红斑和关节痛明显改善，但间质性肺炎进展不利。因此，两次给予甲泼尼龙冲击治疗，但均无反应。此后间质性肺炎迅速进展，她死于呼吸衰竭。尸检结果发现全身横纹肌纤维变性和坏死，肺部有寻常型间质性肺炎和弥漫性肺泡损伤的混合表现。肺部还发现血管炎和纤维素性胸膜炎。未检测到恶性肿瘤。
