RRC ID 4773
著者 Nonomura Y, Koike R, Nishio J, Tsubata R, Kohsaka H, Kubota T, Miyasaka N.
タイトル [A case of dermatomyositis complicated with pneumomediastinum that was successfully treated with cyclosporin A].
ジャーナル Ryumachi
Abstract We reported the case of a 39-year-old man with dermatomyositis (DM) complicated with subcutaneous emphysema and pneumomediastinum during steroid therapy. The patient had complained of muscle weakness, dyspnea and skin eruption on his anterior chest wall 6 months prior to admission. He was diagnosed as having DM on the basis of an elevation in myogenic enzymes, myogenic changes in electromyography, a skin biopsy and a muscle biopsy. Chest roentgenogram revealed interstitial pneumonia (IP) in the lower lobes of the lungs. The administration of prednisolone (60 mg/day) was initiated, which resulted in improvement of DM. Fifteen days after the initiation of the steroid therapy, the patient developed subcutaneous emphysema and pneumomediastinum. Additional administration of cyclosporin A (CsA) enabled us to rapidly taper the dose of prednisolone without aggravating the diseases. Several reports have shown that vasculitis might be involved in the pathogenesis of pneumomediastinum in DM patients. Infection and tissue fragility due to steroid therapy worsen the outcome of those patients. CsA therapy may improve the outcome through the anti-vasculitic- and steroid sparing-effects.
巻・号 41(3)
ページ 653-8
公開日 2001-6-1
PMID 11505515
MeSH Adult Anti-Inflammatory Agents / administration & dosage Anti-Inflammatory Agents / adverse effects Cyclosporine / therapeutic use* Dermatomyositis / complications Dermatomyositis / drug therapy* Humans Immunosuppressive Agents / therapeutic use* Male Mediastinal Emphysema / drug therapy* Mediastinal Emphysema / etiology Prednisolone / administration & dosage Prednisolone / adverse effects Treatment Outcome
リソース情報
遺伝子材料 Ax1w1 (RDB1746)