title: Fatal pneumomediastinum in dermatomyositis without creatine kinase elevation.
abstract: A 41-year-old woman developed fatal pneumomediastinum in the course of dermatomyositis. One characteristic feature of this patient was the relatively mild myositis with slight elevation of serum creatine kinase. In a literature review, some of the patients with dermatomyositis, but not polymyositis, with a very slight elevation of serum creatine kinase tended to develop spontaneous pneumomediastinum during corticosteroid therapy. Since pneumomediastinum is a highly fatal complication in patients with dermatomyositis, only slight elevation of creatine kinase could be a marker for poor prognosis. Thus, mild/minimal myositis in patients with dermatomyositis should be carefully observed irrespective of corticosteroid therapy.
authors.affiliation: Department of Internal Medicine, Mikanagi Gotanada Hospital, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: M
authors.initials: M
authors.lastname: Tomii
authors.forename: S
authors.initials: S
authors.lastname: Kashiwazaki
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000201:enzymology* / Q000209:etiology*; D011379:Prognosis
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D003402:Creatine Kinase