Open AccessASSESSMENT AND MANAGEMENT OF A PATIENT WITH PARANEOPLASTIC DERMATOMYOSITIS
Author(s) -
Ioan-Cristian Lupescu,
Adriana Octaviana Dulămea
Publication year - 2017
Publication title -
romanian journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 4
eISSN - 2069-6094
pISSN - 1843-8148
DOI - 10.37897/rjn.2017.4.6
Subject(s) - medicine , dermatomyositis , malignancy , myopathy , inflammatory myopathy , cyclophosphamide , rash , breast cancer , pathology , surgery , cancer , chemotherapy
Dermatomyositis (DM) is an idiopathic inflammatory myopathy, that can be associated with malignancy. We report the case of a 60-years-old woman, diagnosed and treated for left breast cancer, with residual neoplasm following treatment, who was admitted for generalized myalgias and tetraparesis with predominance of paraparesis. Clinical exam revealed heliotrope rash with bilateral palpebral edema and an erythematous eruption on both thighs and anterior thorax. Motor deficits were predominantly proximal. Paraclinical evaluation excluded other etiologies and revealed elevated serum muscle enzymes and electromyographic pattern of myopathy. An MRI was performed and showed diffuse edematous infiltration of skeletal muscles. Symptoms diminished under corticotherapy, intravenous immunoglobulins and cyclophosphamide. Left mastectomy was eventually performed, but DM symptoms reappeared a few months later. Despite extensive search, no recurrence of tumor was found. However, under treatment, the patient once again recovered, and later resumed her activity.