Skip to main content
Erschienen in: Rheumatology International 4/2017

24.11.2016 | Cases with a Message

Chylothorax in dermatomyositis complicated with interstitial pneumonia

verfasst von: Kentaro Isoda, Takao Kiboshi, Takeshi Shoda

Erschienen in: Rheumatology International | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Chylothorax is a disease in which chyle leaks and accumulates in the thoracic cavity. Interstitial pneumonia and pneumomediastinum are common thoracic manifestations of dermatomyositis, but chylothorax complicated with dermatomyositis is not reported. We report a case of dermatomyositis with interstitial pneumonia complicated by chylothorax. A 77-year-old woman was diagnosed as dermatomyositis with Gottron’s papules, skin ulcers, anti-MDA5 antibody and rapid progressive interstitial pneumonia. Treatment with betamethasone, tacrolimus and intravenous high-dose cyclophosphamide was initiated, and her skin symptoms and interstitial pneumonia improved once. However, right-sided chylothorax began to accumulate and gradually increase, and at the same time, her interstitial pneumonia began to exacerbate, and skin ulcers began to reappear on her fingers and auricles. Although her chylothorax improved by fasting and parenteral nutrition, she died due to further exacerbations of dermatomyositis and interstitial pneumonia in spite of steroid pulse therapy, increase in the betamethasone dosage, additional intravenous high-dose cyclophosphamide and plasma pheresis. An autopsy showed no lesions such as malignant tumors in the thoracic cavity. This is the first report of chylothorax complicated by dermatomyositis with interstitial pneumonia.
Literatur
1.
Zurück zum Zitat Lee CK, Han JM, Lee KN et al (2002) Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus. J Rheumatol 29:1330–1333PubMed Lee CK, Han JM, Lee KN et al (2002) Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus. J Rheumatol 29:1330–1333PubMed
2.
Zurück zum Zitat Zhang L, Zu N, Lin B et al (2013) Chylothorax and chylopericardium in Behçet’s diseases: case report and literature review. Clin Rheumatol 32:1107–1111CrossRefPubMed Zhang L, Zu N, Lin B et al (2013) Chylothorax and chylopericardium in Behçet’s diseases: case report and literature review. Clin Rheumatol 32:1107–1111CrossRefPubMed
3.
Zurück zum Zitat Jinnin M (2013) Myositis and the skin: cutaneous manifestations of dermatomyositis. Brain Nerve 65:1283–1290 (in Japanese) PubMed Jinnin M (2013) Myositis and the skin: cutaneous manifestations of dermatomyositis. Brain Nerve 65:1283–1290 (in Japanese) PubMed
4.
Zurück zum Zitat Kawakami T, Mizoguchi M, Saito R et al (2008) Histopathological evidence of small-vessel vasculitis within the skin and lungs associated with interstitial pneumonia in an adult patient with dermatomyositis. Clin Exp Dermatol 33:415–417CrossRefPubMed Kawakami T, Mizoguchi M, Saito R et al (2008) Histopathological evidence of small-vessel vasculitis within the skin and lungs associated with interstitial pneumonia in an adult patient with dermatomyositis. Clin Exp Dermatol 33:415–417CrossRefPubMed
5.
Zurück zum Zitat Kono H, Inokuma S, Nakayama H et al (2000) Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy. Ann Rheum Dis 59:372–376CrossRefPubMedPubMedCentral Kono H, Inokuma S, Nakayama H et al (2000) Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy. Ann Rheum Dis 59:372–376CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Tsujimura S, Saito K, Tanaka Y (2008) Complete resolution of dermatomyositis with refractory cutaneous vasculitis by intravenous cyclophosphamide pulse therapy. Intern Med 47:1935–1940CrossRefPubMed Tsujimura S, Saito K, Tanaka Y (2008) Complete resolution of dermatomyositis with refractory cutaneous vasculitis by intravenous cyclophosphamide pulse therapy. Intern Med 47:1935–1940CrossRefPubMed
Metadaten
Titel
Chylothorax in dermatomyositis complicated with interstitial pneumonia
verfasst von
Kentaro Isoda
Takao Kiboshi
Takeshi Shoda
Publikationsdatum
24.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Rheumatology International / Ausgabe 4/2017
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-016-3613-1

Weitere Artikel der Ausgabe 4/2017

Rheumatology International 4/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.