[A case of dermatomyositis with severe retinopathy in a patient who died of acute interstitial pneumonia].
Sight threatening ocular complications are rare in adult patients with dermatomyositis. We encountered a 52-year-old female with dermatomyositis who had severe visual disturbance and rapidly progressive intersitial pneumonia. She was admitted to our hospital because of skin erythema, general fatigue, mild fever, and severe bilateral visual disturbance. Rentinal hemorrhages, cotton wool spots, and macular edema were observed in her fundus at the first ophthalmic examination. A diagnosis of dermatomyositis was made because of the myogenic pattern of her electromyogram, elevation of serum creatine kinase, and skin lesions. Oral prednisolone treatment was started and the retinopathy was improved, but was complicated by acute interstitial pneumonia. The interstitial pneumonia was not respond to steroid pulse therapy with methylprednisolone, and the patient died of respiratory failure on the 47th day after the onset of visual symptoms. In adult dermatomyositis patients, the complication of severe retinopathy should be considered as a risk factor for rapid progress of interstitial pneumonia.
Enoki
T
T
Department of Ophthalmology, National Defense Medical College, Saitama-ken, Japan.
Nakagami
T
T
Murakami
A
A
Okisaka
S
S
Nakabayasi
I
I
Yoshizawa
N
N
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy / Q000209:etiology*; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D012164:Retinal Diseases / Q000188:drug therapy / Q000209:etiology*; D012307:Risk Factors
D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D008775:Methylprednisolone