Dermatomyositis case Flashcards
What are the signs and symptoms of DM
Symmetrical muscle weakness in proximal limbs
Photosensitive rash on shoulders, neck
Scaly patches on knuckles, elbows, knees
Red/purple rash with swelling on upper eyelid
Eye edema
What is the pathophysiology of DM?
AI muscle and skin disease => inflammation of skeletal muscles involved in voluntary movement
What investigations would you order
FBC, U&E, CRP, ESR
-all normal => rule out rhabdomyolysis (also presents with proximal muscle weakness)
CK, aldolase, LDH transaminase (skeletal muscle enzymes)
-elevated
AST, ALT
-liver transaminases may also be elevated with skeletal muscle enzymes
Autoantibodies
-ANA => rule out lupus, sjogrens
What would you find on neuro examination
Normal cranial nerves
Symmetrical weakness in neck, hips, shoulder flexors
Sensation ok
What scans would you also order
CXR
-DM sometimes presents with ILD
Screen for cancer
-associated with malignancy
How would you manage DM
- acutely
- chronic
Acute
- Corticosteroids
- IV immunoglobulins
Chronic
- DMARDs
- suncream
- physical, speech therapy