title: Pneumomediastinum in dermatomyositis itself is not a poor prognostic factor: report of a case and review of the literature.
abstract: We describe a 38-year-old man who presented with proximal muscle weakness, myalgia, polyarthralgia, and skin rash and was diagnosed as having dermatomyositis (DM). The patient's symptoms improved with prednisolone therapy. However, myopathy relapsed and pneumomediastinum with subcutaneous emphysema developed. Pneumomediastinum with subcutaneous emphysema rapidly disappeared by the administration of ciclosporin. We reviewed the present case and previously reported cases regarding the clinical characteristics. All of the reported death cases were accompanied by interstitial lung disease (ILD). Although it has been reported that pneumomediastinum in DM can be fatal, the direct cause of patient's death was due to respiratory failure resulting from progressive ILD. Pneumomediastinum without ILD shows a good prognosis.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Tokyo, 105-8461, Japan. k.yoshida@jikei.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.forename: Daitaro
authors.initials: D
authors.lastname: Kurosaka
authors.forename: Isamu
authors.initials: I
authors.lastname: Kingetsu
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hirai
authors.forename: Akio
authors.initials: A
authors.lastname: Yamada
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications*; D013352:Subcutaneous Emphysema / Q000209:etiology
chemical_list: D018501:Antirheumatic Agents; D016572:Cyclosporine