ABSTRACT
La asociación de dermatomiositis y miastenia gravis (MG) es infrecuente, habiéndose comunicado hasta la actualidad únicamente 26 casos. Se presenta el caso de un varón de 69 años diagnosticado de MG 2 años atrás, en tratamiento con piridostigmina, que inicia cuadro agudo de debilidad muscular proximal, artralgias en hombros y elevación de creatincinasa (CK); así como aparición de eritema facial generalizado y pápulas de Gottron. En el estudio de laboratorio se evidenció positividad de anticuerpos antinucleares y anti-Mi2. Ulteriores determinaciones de CK mostraron niveles por encima de 1.000 U/l. Se discute el manejo clínico de este paciente y las implicaciones terapéuticas que plantea la coexistencia de ambas entidades (AU)
The association of dermatomyositis with myasthenia gravis (MG) is uncommon, having been reported so far in only 26 cases. We report the case of a 69 year-old man diagnosed with MG two years ago and currently treated with piridostigmyne. The patient developed acute proximal weakness, shoulder pain and elevated creatine-kinase (CK). He also developed generalized facial erythema and Gottron's papules. Laboratory tests showed positive antinuclear and anti-Mi2 antibodies. Further analysis confirmed CK levels above 1000 U/l. The clinical management of the patient and the therapeutic implications derived from the coexistence of both entities are discusssed (AU)
Subject(s)
Humans , Male , Middle Aged , Dermatomyositis/complications , Dermatomyositis , Myasthenia Gravis/complications , Myasthenia Gravis , Muscle Weakness/complications , Muscle Weakness/diagnosis , Antibodies, Antinuclear , Muscular Diseases/complications , Muscular Diseases/diagnosis , Prednisone/therapeutic use , Muscle Weakness/physiopathology , Muscle Weakness/therapy , Muscle Weakness , Mi-2 Nucleosome Remodeling and Deacetylase Complex , Erythema/complications , Microscopic Angioscopy , Muscle StrengthABSTRACT
The association of dermatomyositis with myasthenia gravis (MG) is uncommon, having been reported so far in only 26 cases. We report the case of a 69 year-old man diagnosed with MG two years ago and currently treated with piridostigmyne. The patient developed acute proximal weakness, shoulder pain and elevated creatine-kinase (CK). He also developed generalized facial erythema and Gottron's papules. Laboratory tests showed positive antinuclear and anti-Mi2 antibodies. Further analysis confirmed CK levels above 1000 U/l. The clinical management of the patient and the therapeutic implications derived from the coexistence of both entities are discusssed.
