An adult case of dermatomyositis complicated with cecum perforation and panniculitis

A. Suwa, Michito Hirakata, N. Hama, K. Ishiyama, K. Amano, H. Tanaka, J. Fujimaki, T. Mimori, S. Inada, M. Akizuki

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Abstract

The case of dermatomyositis complicated with cecum perforation and panniculitis occurred in a 62-year-old woman was reported. She was admitted to Keio University Hospital with a history of proximal muscular weakness, and dysphagia. Physical examination showed erythema over the face and shoulder. Serum level of muscle enzymes was remarkably increased. The diagnosis of dermatomyositis was made based on proximal muscular weakness, elevated serum level of muscle enzymes and myogenic change of electromyocardiogram. The treatment with 60 mg/day of prednisolone was started, and was a good response. However, 7 months later the disease became active again when the amount of prednisolone was reduced to 13 mg/day. Subsequently she complained of abdominal pain on the right lower quadrant. The surgical findings included peritonitis due to the perforation of the cecum and multiple ulcers of the cecum. After operation, azathioprine was added. Four years and 9 months later, she noticed skin erythema with ulceration and subcutaneous nodule. Skin biopsy indicated the findings of the panniculitis with membrano-cystic lesion. It was thought that both cecum perforation and panniculitis were caused by angiopathy which was often seen in childhood dermatomyositis.

Original languageEnglish
Pages (from-to)60-66
Number of pages7
JournalNihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology
Volume20
Issue number1
Publication statusPublished - 1997

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Panniculitis
Dermatomyositis
Cecum
Muscle Weakness
Erythema
Prednisolone
Muscles
Skin
Azathioprine
Enzymes
Deglutition Disorders
Peritonitis
Serum
Abdominal Pain
Physical Examination
Ulcer
Biopsy

Cite this

An adult case of dermatomyositis complicated with cecum perforation and panniculitis. / Suwa, A.; Hirakata, Michito; Hama, N.; Ishiyama, K.; Amano, K.; Tanaka, H.; Fujimaki, J.; Mimori, T.; Inada, S.; Akizuki, M.

In: Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology, Vol. 20, No. 1, 1997, p. 60-66.

Research output: Contribution to journalArticle

Suwa, A, Hirakata, M, Hama, N, Ishiyama, K, Amano, K, Tanaka, H, Fujimaki, J, Mimori, T, Inada, S & Akizuki, M 1997, 'An adult case of dermatomyositis complicated with cecum perforation and panniculitis', Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology, vol. 20, no. 1, pp. 60-66.
Suwa, A. ; Hirakata, Michito ; Hama, N. ; Ishiyama, K. ; Amano, K. ; Tanaka, H. ; Fujimaki, J. ; Mimori, T. ; Inada, S. ; Akizuki, M. / An adult case of dermatomyositis complicated with cecum perforation and panniculitis. In: Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology. 1997 ; Vol. 20, No. 1. pp. 60-66.
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