title: Novel gastrointestinal tract manifestations in juvenile dermatomyositis.
abstract: We report a case of juvenile dermatomyositis in which a dilated atonic esophagus was associated with delayed gastric emptying and intestinal mucosal thickening, resulting in a radiographic "stacked coin" appearance. These findings, which can also occur in infectious, neoplastic, or other immune-mediated diseases, broaden the spectrum of gastrointestinal tract manifestations in juvenile dermatomyositis. Physicians should be alert for these treatable manifestations in children with myositis who present with unexplained gastrointestinal symptoms, which are reversible with immunosuppressive therapy.
authors.affiliation: Division of Monoclonal Antibodies, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland 20892, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Laskin
authors.forename: P
authors.initials: P
authors.lastname: Choyke
authors.forename: G F
authors.initials: GF
authors.lastname: Keenan
authors.forename: F W
authors.initials: FW
authors.lastname: Miller
authors.forename: L G
authors.initials: LG
authors.lastname: Rider
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001466:Barium Sulfate; D002675:Child, Preschool; D003287:Contrast Media; D003882:Dermatomyositis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic; D004386:Duodenum / Q000000981:diagnostic imaging / Q000473:pathology*; D004733:Enema; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D006984:Hypertrophy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007583:Jejunum / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011859:Radiography; D013256:Steroids
chemical_list: D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D001466:Barium Sulfate