Generalized subcutaneous edema as a rare manifestation of dermatomyositis: clinical lesson from a rare feature.

Abstract

Generalized subcutaneous edema is a very rare manifestation of inflammatory myopathies. A 61-year-old woman presented with classic signs and symptoms of dermatomyositis. She was also noted to have generalized edema that was so florid that an alternative diagnosis was considered. Her disease was resistant to corticosteroids, azathioprine, and mycophenolate mofetil. Intravenous administration of immunoglobulins was started because of marked worsening of her disease-muscle weakness, generalized anasarca, and involvement of her bulbar muscles. This led to dramatic resolution of her subcutaneous edema and significant improvement of her skin and muscle disease. As the initial screen for malignancy was negative, a positron emission tomography-computed tomography scan was requested, which interestingly showed a metabolically active cervical tumor. Anasarca is an unusual manifestation of dermatomyositis. In treatment-refractory cases, it seems reasonable to consider positron emission tomography scan in excluding underlying malignant disease.

• Authors: Muhammad Haroon, Ahmed Eltahir, Sinead Harney
• Journal: Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 17 Issue 3 Pg. 135-7 (Apr 2011) ISSN: 1536-7355 [Electronic] United States
• PMID: 21441819 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous

Topics

• Dermatomyositis (complications, etiology, pathology)
• Edema (drug therapy, etiology)
• Female
• Humans
• Immunoglobulins, Intravenous
• Lung Neoplasms (diagnostic imaging, radiotherapy, secondary)
• Middle Aged
• Neoplasms, Squamous Cell (diagnostic imaging, radiotherapy, secondary)
• Radiotherapy
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome
• Uterine Cervical Neoplasms (complications, diagnostic imaging, radiotherapy)