[A case of small cell lung cancer with dermatomyositis that deteriorated with leukocytopenia due to chemotherapy].
A 64-year-old woman presented skin lesions on her face, upper extremities and finger erythema (heliotropism and Gottron's sign). She had weakness in her lower extremities. She was given a diagnosis of dermatomyositis (DM), because the serum examination showed that a myositis-specific antibody was positive whereas Jo-1 antibody was negative. The findings of chest X-ray and computed tomography showed that she had limited small cell lung cancer, but no interstitial pneumonia. She was treated with standard chemotherapy consisting of cisplatin and etoposide with accelerated hyperfractionation radiotherapy. She showed partial response to the treatment, whereas the skin lesions and muscle weakness deteriorated accompanied with bone marrow suppression due to chemotherapy. Skin and muscle biopsy were performed and pathological findings showed typical perivasculitis infiltrated with lymphocytes in muscle and skin. With the recovery of bone marrow suppression and partial response due to chemotherapy, the skin lesions improved and creatine kinase became normalized. She was given a diagnosis of paraneoplastic DM. Since severe leukocytopenia paralleled the deterioration of DM, the decrease of peripheral white blood cell counts, especially regulatory T cell counts, may be associated with DM activity.
Numata
Takanori
T
Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine.
Kawabata
Ayako
A
Fujita
Yu
Y
Bono
Keiko
K
Tamura
Kumi
K
Mikami
Jiro
J
Wakui
Hiroshi
H
Ito
Saburo
S
Yumino
Yoko
Y
Kawaishi
Makoto
M
Kuwano
Kazuyoshi
K
D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D003882:Dermatomyositis / Q000150:complications*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000188:drug therapy*; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000150:complications*; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy*
D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D002945:Cisplatin