Dermatomyositis case Flashcards

1
Q

What are the signs and symptoms of DM

A

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

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2
Q

What is the pathophysiology of DM?

A

AI muscle and skin disease => inflammation of skeletal muscles involved in voluntary movement

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3
Q

What investigations would you order

A

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

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4
Q

What would you find on neuro examination

A

Normal cranial nerves

Symmetrical weakness in neck, hips, shoulder flexors

Sensation ok

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5
Q

What scans would you also order

A

CXR
-DM sometimes presents with ILD

Screen for cancer
-associated with malignancy

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6
Q

How would you manage DM

  • acutely
  • chronic
A

Acute

  • Corticosteroids
  • IV immunoglobulins

Chronic

  • DMARDs
  • suncream
  • physical, speech therapy
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