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

A case of juvenile dermatomyositis developing intermuscular fascial plane calcification in the thighs early in the course of the disease is described. The use of CT was helpful in localizing the calcium deposits between the muscular layers before surgical removal of the calcification. These procedures may have prevented fistulization and development of contracture of the joints.
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PMID:CT assessment of calcinosis in a patient with dermatomyositis. 373 19

Severe osteoporosis with multiple vertebral fractures occurred in two girls receiving prolonged high dose corticosteroids for relapsing dermatomyositis. Sodium fluoride, supplemented with calcium and vitamin D, helped control secondary osteoporosis in one case and should be considered as part of the curative treatment of corticoid induced osteoporosis.
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PMID:Fluoride treatment in corticosteroid induced osteoporosis. 381 18

In this review, the cardiac lesions which develop in association with the various collagen-vascular diseases are described. In rheumatoid arthritis, the most frequent lesions are: fibrous obliterative pericarditis, with pericardial deposits of calcium, fibrin, cholesterol, and rheumatoid granulomas; granulomatous or nonspecific myocarditis; valvulitis, vasculitis, and amyloid deposits. In ankylosing spondylitis, the lesions involve mainly the valves (aortic and mitral valves) and the aorta. In systemic lupus erythematosus, the predominant cardiovascular lesions are: pericarditis, Libman-Sacks endocarditis, nonspecific myocarditis, vasculitis with fibrinoid necrosis, and acceleration of atherosclerosis. In scleroderma, the main cardiac lesion is fibrosis with only scanty inflammatory cells; pericarditis and nonbacterial thrombotic endocarditis also occur. In dermatomyositis/polymyositis, fibrous or fibrinous pericarditis can occur, as well as myocarditis with infiltrates of lymphocytes and plasma cells and with degeneration and necrosis of myocytes; valvulitis is uncommon except when the disease is related to mucinous adenocarcinoma. In polyarteritis nodosa, various stages of necrotizing vasculitis involve all layers of the arterial walls; foci of myocardial necrosis of various sizes can occur in association with these lesions; cardiac hypertrophy related to hypertension and pericarditis related to uremia, may also be found. In Wegener's granulomatosis, pericarditis, inflammatory infiltrates, necrotizing granulomas, and vasculitis have been observed in the heart.
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PMID:Cardiovascular lesions in collagen-vascular diseases. 391 76

Calcinosis, the process whereby calcium salts are deposited in soft tissues, may be idiopathic, metastatic or dystrophic. Metastatic calcinosis develops in a variety of systemic diseases characterized by either hypercalcemia, hyperphosphatemia, or both. Dystrophic calcinosis refers to calcification of previously damaged or necrotic tissue. It may be found accompanying inflammatory or degenerative conditions and is frequently associated with connective tissue diseases. When pathologic calcification is widespread, an attempt must be made to determine the underlying cause. A case is presented in which there was multifocal calcium deposition in soft tissues, including an intra-oral site. The patient also exhibited severe arthritis, sicca syndrome, focal alopecia and vitiligo. In view of this clinical spectrum, one of the "collagen diseases" (dermatomyositis, lupus erythematosus, rheumatoid arthritis, and scleroderma) was suspected as a predisposing factor for disseminated calcinosis. When diagnostic workup failed to reveal a specific connective tissue disease, it was concluded that "undifferentiated connective tissue disease" was responsible for dystrophic calcinosis.
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PMID:Oral lesion in a patient with calcinosis and arthritis: case report and differential diagnosis. 391 55

We have examined whether peripheral blood mononuclear cells from patients with polymyositis-dermatomyositis (PM-DM) incubated with autologous muscle release mediators that can affect the Ca2+ binding by sarcoplasmic reticulum (SR), the key regulator of muscle contraction. Peripheral blood mononuclear cells from 11 patients with early, active, and untreated PM-DM and from 20 controls were incubated with various dilutions (ranging from 1:60 to 1:4800 wt/vol) of autologous muscle homogenates. Mononuclear cells from eight of 11 patients with PM-DM underwent proliferation as assessed by 3H-thymidine incorporation into mononuclear cells (stimulation indices ranging from 3 to 14). Supernatants from muscle-stimulated mononuclear cells suppressed the adenosine triphosphate-dependent Ca2+ binding by SR membranes derived from rat skeletal muscles. Neither proliferative responses of mononuclear cells nor release of mediators suppressing calcium binding by SR was observed in mononuclear cell cultures of controls. The factor(s) producing suppression of calcium binding by SR was nondialyzable, and its effect on SR was concentration dependent. These results suggest that mononuclear cells in PM-DM are sensitized to autologous muscle and release a soluble factor(s) that inhibits the function of SR muscle membrane. These findings may have important implications in the pathogenesis of muscle weakness in PM-DM.
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PMID:Mononuclear cells from patients with polymyositis inhibit calcium binding by sarcoplasmic reticulum. 394 Dec 92

The deposition of calcium and phosphorous salts in the soft tissues can be classified into three categories: metastatic calcification, dystrophic calcification, and calcinosis. Metastatic calcification occurs when the calcium-phosphorous levels are elevated. The calcifications involve normal tissues. Associated disease include hyperparathyroidism, neoplasms, milk-alkali syndrome, hypervitaminosis D, and tumoral calcinosis. Dystrophic calcification occurs in the presence of normal metabolism in damaged or devitalized tissues. Disorders included in this classification are: Ehlers-Danlos syndrome, pseudoxanthoma elasticum, arteriosclerosis obliterans, venous calcifications, crystal deposition disorders, and calcification resulting from neurologic disorders. Calcinosis is also found in persons with normal metabolism. It occurs most often in subcutaneous tissues, skin, and related connective tissues. Associated disorders include: calcinosis universalis, calcinosis circumscripta, scleroderma, dermatomyositis, and systemic lupus erythematosus.
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PMID:A review of soft tissue calcifications. 404 12

The case of a young female child with dermatomyositis and flexion contracture in the dominant hand secondary to calcinosis is presented. Function was improved by flexor tenosynovectomy and removal of calcium deposits.
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PMID:Calcinosis of the flexor and extensor tendons in dermatomyositis--case report. 651 5

The radiographs of 40 patients with childhood dermatomyositis, an uncommon inflammatory disease, were reviewed. Four distinct patterns of calcification were identified: deep calcareal masses, superficial calcareal masses, deep linear deposits, and a lacy, reticular, subcutaneous deposition of calcium encasing the torso (not emphasized in recent literature). This linear reticular pattern of calcification was associated with a severe unremitting clinical course. Soft-tissue calcification was identified in 40% of cases, a lower incidence than previously reported. No patient in this series had acroosteolysis or pulmonary parenchymal disease, radiographic findings more commonly associated with childhood scleroderma.
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PMID:Patterns of calcification in childhood dermatomyositis. 660 16

Defatted joint fluid pellets from 4 patients with the "Milwaukee shoulder" syndrome, an aspirate of milky fluid from subcutaneous tissue of a girl with dermatomyositis/calcinosis, and 2 rabbit synovial membranes calcified by calciphylaxis were studied by Fourier transform infrared analysis. This method permits sequential electronic subtraction ("stripping") of known patterns of highly characterized reference compounds from an unknown sample pattern. Collagen and hydroxyapatite, with carbonate partially (1-3%) substituted for phosphate, and to a lesser extent hydroxyl, were found in all samples. Octacalcium phosphate (OCP) was found in all samples except that from a patient with synovial chondromatosis which contained tricalcium phosphate (TCP). Sulfate was found in 2 of the shoulder joint fluid specimens. An unidentified organic phase was present in all samples. This study confirms recent observations by others that pathologic calcifications contain several mineral phases. These data raise the possibility that hydroxyapatite nucleation may be controlled by hydrolytic alteration of precursor calcium phosphate phases such as OCP or TCP. Studies of the biologic effects of synthetic calcium phosphate crystals must take into account the existence of several crystalline phases in natural pathologic calcifications.
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PMID:Crystal populations in human synovial fluid. Identification of apatite, octacalcium phosphate, and tricalcium phosphate. 662 80

The medical records of 47 children with dermatomyositis who were seen in the pediatric rheumatology clinic at the University of Michigan between 1964 and 1982 were reviewed. Although most children with dermatomyositis have a good prognosis, the best predictor of both good functional recovery and minimal calcinosis is early treatment after the onset of symptoms, using high doses of prednisone for an adequate length of time. Of the children given such treatment, 78% had good functional outcomes, and disabling calcinosis was seen in 20% or less. Children given treatment late in the course of disease and with low doses of steroids are more likely to be functionally limited and have a greater amount of dystrophic calcium salt deposition. In our study, only 33% of patients given such treatment had a mild disease course with good functional outcome. We have identified a subgroup of children with dermatomyositis who appear to do poorly despite optimal therapeutic regimens. These patients are distinguished by a severe disease course responding minimally to corticosteroid therapy and manifested by persistent muscle weakness, elevations of muscle enzyme activity, and severe generalized cutaneous vasculitis. These children are at high risk for the development of exoskeleton-like calcification; consideration should be given to combined immunosuppressive therapy early in the course of disease.
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PMID:Childhood dermatomyositis: factors predicting functional outcome and development of dystrophic calcification. 664 23


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