See Y, Martin K, Rooney M, Woo P
Department of Rheumatology, Great Ormond Street Hospital for Sick Children, London.
Br J Rheumatol. 1997 Aug;36(8):912-6. doi: 10.1093/rheumatology/36.8.912.
We report two boys with juvenile dermatomyositis (JDM) complicated by pancreatitis. One also had hepatitis and probably mild bowel vasculitis, while the other had catastrophic bowel vasculitis with multiple perforations. Both were on corticosteroids, but had features of active vasculitis. The former improved with high-dose i.v. pulsed methylprednisolone, while the latter improved only after immunosuppression with i.v. methylprednisolone, cyclophosphamide and plasmapheresis. Although bowel vasculitis is a known complication of severe JDM, pancreatitis and hepatitis are extremely rare. We have found in a literature search only three other reports of pancreatitis complicating JDM. We wish to alert physicians that pancreatitis may develop in JDM. It should be considered as a differential diagnosis in the child with active disease who develops abdominal pain. Control of vasculitis with adequate immunosuppression, as well as general supportive measures, may be valuable in the treatment of pancreatitis in JDM.
我们报告了两名患有幼年皮肌炎（JDM）并并发胰腺炎的男孩。其中一名还患有肝炎，可能还有轻度肠道血管炎，而另一名则患有灾难性的肠道血管炎并伴有多处穿孔。两人均接受了皮质类固醇治疗，但都有活动性血管炎的特征。前者经大剂量静脉注射脉冲甲基强的松龙后病情好转，而后者仅在接受静脉注射甲基强的松龙、环磷酰胺和血浆置换免疫抑制治疗后才有所改善。虽然肠道血管炎是严重JDM的已知并发症，但胰腺炎和肝炎极为罕见。我们在文献检索中仅发现另外三篇关于JDM并发胰腺炎的报告。我们希望提醒医生，JDM可能会并发胰腺炎。对于患有活动性疾病且出现腹痛的儿童，应将其视为鉴别诊断。通过充分的免疫抑制控制血管炎以及一般支持措施，可能对JDM并发胰腺炎的治疗有价值。
