[Pneumomediastinum complicating the anti-synthetase syndrome].
BACKGROUND
Pneumomediastinum is a rare but classical complication of dermatomyositis. Its development is a serious matter and necessitates prompt recourse to aggressive treatment with corticosteroids combined with immuno-suppressants or intravenous human immunoglobulin.


METHODS
We report the case of a 63 year old woman presenting with pulmonary infiltration, in the presence of dermatomyositis, as a clinical manifestation of the anti-synthetase syndrome. The progress was rapidly unfavourable with pneumomediastinum and acute respiratory distress despite initial treatment with corticosteroids followed by human immunoglobulin and immunosuppressants.


CONCLUSIONS
The identification of cutaneous or muscular signs in the initial investigation of a pulmonary infiltrate should lead to a search for anti-synthetase antibodies in order to determine the optimal clinical management as quickly as possible.
Saint-Georges
F
F
Service de Pneumologie, Hôpital Saint-Philibert, 115, rue du grand but, 59462 Lomme Cedex, France. fr.roy@libertysurf.fr
Mulliez
P
P
Lebas
D
D
Modiano
P
P
Bisch
D
D
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000604:Amino Acyl-tRNA Synthetases / Q000276:immunology; D000974:Antibodies, Antinuclear / Q000032:analysis / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D015153:Blotting, Western; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008025:Ligases / Q000276:immunology*; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D008875:Middle Aged; D013902:Radiography, Thoracic; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D008025:Ligases; D000604:Amino Acyl-tRNA Synthetases