A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A.
We describe a rare case of a 46-year-old Japanese man with dermatomyositis (DM) and interstitial lung disease who developed spontaneous pneumomediastinum and subcutaneous emphysema. Relatively mild myositis, mild elevation of CK values and the absence of anti-Jo-1 antibody were observed and the case was similar to amyopathic DM. Treatment of this patient with oral prednisolone and cyclosporin A (CsA) was effective for the myositis and interstitial lung disease. The administration of CsA enabled rapid tapering of the dose of prednisolone without aggravating the disease. Pneumomediastinum and subcutaneous emphysema disappeared 5 months later without recurrence. The serum levels of KL-6 were monitored every 2 weeks to help determine whether this may have contributed to the recurrence of interstitial pneumonitis. This is a rare case of pneumomediastinum in a patient with DM.
Kuroda
T
T
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-Dori Niigata City, 951-8510, Japan. kurodat@med.niigata-u.ac.jp
Morikawa
H
H
Satou
T
T
Tanabe
Y
Y
Murakami
S
S
Ito
S
S
Nakan
M
M
Gejyo
F
F
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000941:Antigens / Q000097:blood; D000951:Antigens, Neoplasm; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins; D011239:Prednisolone / Q000008:administration & dosage; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D000941:Antigens; D000951:Antigens, Neoplasm; D006023:Glycoproteins; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins; D016572:Cyclosporine; D011239:Prednisolone