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Query: UMLS:C0011633 (dermatomyositis)
 4,181 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of dermatomyositis associated with prostatic carcinoma. A 69-year-old male was admitted to the Department of Internal Medicine with the chief complaint of general fatigue, appetite loss and facial anthema. Abdominal ultrasound demonstrated swollen periaortic lymph nodes and the margin of prostate was unclear. Prostatic carcinoma was suspected based on digital rectal examination, so he was admitted to our department. Serum prostate specific antigen level was 190 ng/ml. He was examined by a dermatologist because of deterioration of anthema. Dermatomyocitis was demonstrated by dermatoses (edema erythema at face, neck and limbs, nail fold thrombosis and poikiloderma), high serum level of creatine phosphokinase and a decrease in muscular strength (especially at the proximal musculus). There was no interstitial pneumonitis or malignancy of the digestive system. On needle biopsy of the prostate and quadriceps femoris muscle, prostatic carcinoma (poorly differentiated adenocarcinoma, Gleason score 5 + 5) and myositis were suspected. The stage of prostatic carcinoma was T4N1M1. The patient was treated by administration of diethylstilbestrol phosphate and prednisolone for prostatic carcinoma and dermatomyositis, respectively, but he died of multiple metastasis of the tumor 1 year and 5 months later. Dermatomyocitis is associated with malignancy more frequently than any other collagen disease. In Japan, it is frequently complicated by gastric, lung and mammory cancers, but rarely by prostatic carcinoma. To our knowledge, this is the fourth case of prostatic carcinoma associated with dermatomyocitis in Japan.
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PMID:[A case of dermatomyositis associated with prostatic carcinoma: a case report]. 1510 Nov 64

Because the clinical significance of von Willebrand factor (vWF), a marker of endothelial injury, has not been well studied in adult patients with dermatomyositis (DM), we evaluated whether plasma vWF levels are useful as an index of disease activity in these patients. We measured plasma vWF antigen levels in 11 patients with active adult DM, 13 patients with inactive DM, and 18 healthy subjects using an enzyme-linked immunosorbent assay. The association of vWF level with clinical condition and muscle-derived enzyme leakage among DM patients was examined using analysis of covariance and logistic regression analysis. Furthermore, we studied the effects of treatment on the vWF antigen level. The mean vWF antigen level was significantly higher in active DM patients than in inactive DM patients and healthy subjects. Higher vWF levels were associated with clinical symptoms, such as general fatigue, fever, and muscle weakness. They were also associated with the levels of aspartate aminotransferase, alanine aminotransferase, and aldolase, but not with those of lactate dehydrogenase and creatine kinase (CK). vWF antigen was correlated with muscle enzymes except for CK. The plasma vWF levels in six patients with active DM significantly decreased after successful corticosteroid treatment. Plasma vWF level may be considered a useful marker of disease activity in adult DM patients.
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PMID:Clinical significance of von Willebrand factor in patients with adult dermatomyositis. 1556 94

Systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), and dermatomyositis (DM)/polymyositis (PM) may be encountered in geriatric patients due to improved survival rates in patients with younger ages of onset or from elderly-onset (EO) disease. EO disease accounts for up to 20% of patients affected by these disorders, and is typically insidious rather than acute. Whereas SS and DM/PM are considered autoimmune diseases with distinct organ specificity, SLE is a systemic disorder that may affect multiple organ systems. Commonly used clinical and laboratory criteria for defining and diagnosing these diseases were largely developed for patients age <65, and need to be modified in the geriatric patient. Therapeutic strategies include attention to ongoing drug regimens, medical comorbidities, and the roles of fatigue, depression, and arthropathy. Each disease may be responsive to low-dose corticosteroids, with a role for first or second-line immunosuppressives as steroid-sparing agents.
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PMID:Geriatric autoimmune diseases: systemic lupus erythematosus, Sjogren's syndrome, and myositis. 1587 83

The association between dermatomyositis and restrictive cardiomyopathy has not been reported before. We present here the clinical, echocardiographic and muscle biopsy data for a patient with dermatomyositis and restrictive cardiomyopathy. In a 78-year-old male with a history of arterial hypertension, recurrent episodes of atrial fibrillation and syncopes, rupture of an infra-renal aortic aneurysm with complications (recurrent QT-prolongation, lumbo-sacral plexopathy, transient ischaemic attack, peripheral embolism), monoclonal gammopathy, subdural haematoma, focal seizures, megaloblastic anaemia, leucopenia, eosinophilia, elevated muscle enzymes and increasing tiredness, dermatomyositis was diagnosed upon clinical presentation, muscle enzyme and muscle biopsy findings. Cardiological examination revealed atrial fibrillation, left anterior hemiblock and restrictive cardiomyopathy. After the exclusion of various differentials for restrictive cardiomyopathy, a causative relationship between restrictive cardiomyopathy and dermatomyositis was assumed. This case suggests the need for suspecting restrictive cardiomyopathy in patients with dermatomyositis. Patients with dermatomyositis should undergo a comprehensive cardiological investigation as soon as the neurological diagnosis is established.
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PMID:Restrictive cardiomyopathy in dermatomyositis. 1676 71

Children are able to resist fatigue better than adults during one or several repeated high-intensity exercise bouts. This finding has been reported by measuring mechanical force or power output profiles during sustained isometric maximal contractions or repeated bouts of high-intensity dynamic exercises. The ability of children to better maintain performance during repeated high-intensity exercise bouts could be related to their lower level of fatigue during exercise and/or faster recovery following exercise. This may be explained by muscle characteristics of children, which are quantitatively and qualitatively different to those of adults. Children have less muscle mass than adults and hence, generate lower absolute power during high-intensity exercise. Some researchers also showed that children were equipped better for oxidative than glycolytic pathways during exercise, which would lead to a lower accumulation of muscle by-products. Furthermore, some reports indicated that the lower ability of children to activate their type II muscle fibres would also explain their greater resistance to fatigue during sustained maximal contractions. The lower accumulation of muscle by-products observed in children may be suggestive of a reduced metabolic signal, which induces lower ratings of perceived exertion. Factors such as faster phosphocreatine resynthesis, greater oxidative capacity, better acid-base regulation, faster readjustment of initial cardiorespiratory parameters and higher removal of metabolic by-products in children could also explain their faster recovery following high-intensity exercise.From a clinical point of view, muscle fatigue profiles are different between healthy children and children with muscle and metabolic diseases. Studies of dystrophic muscles in children indicated contradictory findings of changes in contractile properties and the muscle fatigability. Some have found that the muscle of boys with Duchenne muscular dystrophy (DMD) fatigued less than that of healthy boys, but others have reported that the fatigue in DMD and in normal muscle was the same. Children with glycogenosis type V and VII and dermatomyositis, and obese children tolerate exercise weakly and show an early fatigue. Studies that have investigated the fatigability in children with cerebral palsy have indicated that the femoris quadriceps was less fatigable than that of a control group but the fatigability of the triceps surae was the same between the two groups. Further studies are required to elucidate the mechanisms explaining the origins of muscle fatigue in healthy and diseased children. The use of non-invasive measurement tools such as magnetic resonance imaging and magnetic resonance spectroscopy in paediatric exercise science will give researchers more insight in the future.
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PMID:Muscle fatigue during high-intensity exercise in children. 1712 27

There have been few reports of dermatomyositis causing ascites. Here we report a case of a 63-year-old man complaining of general fatigue and gastromegaly. Abdominal examination revealed distension without tenderness. Serum myogenic enzyme was elevated. Electromyographic investigation indicated low amplitude signs, which were compatible with muscle disorder. Abdominal paracentesis on the fifth day yielded 2,500 ml clear, serous fluid. The specific gravity was 1.026 (range 1.005-1.015), with a positive Rivalta reaction, 3.4 g/dl total protein, and 1.59 g/dl albumin, suggesting exudate. Excluding the other causes of exudative ascites, we considered that the ascites was caused by dermatomyositis.
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PMID:Dermatomyositis with massive ascites. 1728 35

Idiopathic inflammatory myopathies (IIMs), comprising polymyositis, dermatomyositis, and inclusion-body myositis, are characterized by inflammatory cell infiltrates in skeletal muscle tissue, muscle weakness, and muscle fatigue. The cellular infiltrates often consist of T lymphocytes and macrophages but also, in some cases, B lymphocytes. Emerging data have led to improved phenotypic characterization of the inflammatory cells, including their effector molecules, in skeletal muscle, peripheral blood, and other organs that are frequently involved, such as skin and lungs. In this review we summarize the latest findings concerning the role of T lymphocytes, B lymphocytes, dendritic cells, and other antigen-presenting cells in the pathophysiology of IIMs.
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PMID:Immune mechanisms in the pathogenesis of idiopathic inflammatory myopathies. 1738 31

A pityriasis rubra pilaris-like eruption has been described in patients with dermatomyositis. We describe an 11-year-old girl with dermatomyositis who had additional clinical findings of pityriasis rubra pilaris. Over a year, she developed muscle weakness, increasing fatigue, and a markedly elevated creatinine kinase level in addition to her cutaneous eruption and was seen in our clinic for these complaints. A year earlier, when a generalized, scaly erythematous eruption had appeared, she had been diagnosed as pityriasis rubra pilaris clinically and histopathologically. Dermatologic examination found scaling erythematous plaques involving the trunk and upper and lower extremities. Islands of unaffected skin were intermingled with erythematous plaques that were characteristic of pityriasis rubra pilaris. A skin biopsy specimen showed the findings of dermatomyositis and that diagnosis was made. The laboratory findings, electromyographic pattern, and muscle biopsy were also consistent with dermatomyositis. Her presentation is interesting, as she had been diagnosed as pityriasis rubra pilaris both clinically and histopathologically 1 year earlier and, although the cutaneous lesions had not changed, a diagnosis of dermatomyositis was made a year later.
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PMID:Dermatomyositis with a pityriasis rubra pilaris-like eruption: an uncommon cutaneous manifestation in dermatomyositis. 1746 14

Ovarian carcinoma possesses cutaneous and paraneoplastic associations. The aim of this study was to review the paraneoplastic associations and metastatic presentations of ovarian carcinoma. PubMed was searched through December 2006 for references to cutaneous metastatic ovarian carcinoma (CMOC). CMOC occurs in 2-7% of cases, manifests in advanced disease and indicates a poor prognosis. The paraneoplastic associations of ovarian carcinoma include acanthosis nigricans, Raynaud's phenomenon, scleroderma, dermatomyositis and palmar fasciitis with polyarthritis. Dermatomyositis, in particular, can precede the diagnosis of ovarian carcinoma. Ovarian carcinoma has many cutaneous paraneoplastic effects and metastatic presentations, all of which portend a poor prognosis. Dermatomyositis is sometimes the initial manifestation of ovarian cancer, thus women > 40 years of age with dermatomyositis should be checked for ovarian carcinoma. It is possible that paraneoplastic dermtomyosititis can be distinguished from nonparaneoplastic dermatomyostitis by the former's lack of (i) associated Raynaud's phenomenon, (ii) response to treatment, (iii) autoantibodies, (iv) overlap and association with other collagen vascular diseases and (v) the presence of the prodromal symptoms of ovarian carcinoma such as gastrointestinal symptoms, urinary symptoms and/or fatigue or malaise.
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PMID:A review of the cutaneous paraneoplastic associations and metastatic presentations of ovarian carcinoma. 1798 53

Raynaud's phenomenon, fatigue and pain (myalgia and arthralgia) are important presenting symptoms of pediatric-onset mixed connective tissue disease. The difficulty is that many adolescent girls complain of pain along with fatigue without evidence for serious disease. However, in patients with Raynaud's phenomenon one should search for evidence of connective tissue diseases. Capillaroscopy could be helpful since capillary changes of the SD-type significantly correlate with future development of scleroderma spectrum disorders. Symptoms of MCTD change in most patients during the disease course: in general the inflammatory features that are also seen in systemic lupus erythematosus and juvenile dermatomyositis have the tendency to disappear over years, but Raynaud's phenomenon is persistent and scleroderma symptoms become progressively prominent. Long-lasting remission occurs only in a minority of patients, while the majority has mild disease activity. Mortality in children with MCTD is lower than in adults. Since a change of symptoms is in the nature of the disease, a thorough and frequent evaluation of children with (probable) MCTD is important to detect organ involvement, which should be treated at an early (pre-symptomatic) stage. We present a diagnostic workup scheme for children and adolescents with propable MCTD.
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PMID:Diagnostic workup for mixed connective tissue disease in childhood. 1884 72


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