Oropharyngeal dysphagia in dermatomyosites: case report and literature review.
We present a rare case of dermatomyosites associated with severe oropharyngeal dysphagia. A 13 year old female patient, being followed at the Rheumatologic Department, was referred to the Otolaryngology Department of the University of São Paulo School of Medicine Hospital. She complained of swallowing problems, especially with solids. Following our dysphagia study protocol, we employed a speech pathologist and otolaryngology evaluation, mainly for clinical history, examination of anatomical structures involved with swallowing events, cranium nerves integrity and videoendoscopic swallowing study. We diagnosed severe oropharyngeal dysphagia, with aspiration of saliva and food of all consistencies. We advised against oral feeding and recommended a diet through a gastric tube. She started with therapy and xerostomia medication, together with the treatment of the base disease. The patient showed a significant improvement, noticed by the clinical evaluation and the control videoendoscopic swallowing study, with the possibility of returning to oral feeding. The authors stress the incidence of oropharyngeal dysphagia in dermatomyosites and suggest the videoendoscopic swallowing study as a good exam for diagnosis and follow-up of these patients.
Lemos
Elza Maria
EM
Graduate student - Otorhinolaryngology - HCFMUSP, Head of the Pediatric Dysphagia Ward - HCFMUSP (University of São Paulo Medical School. Electronic address: elza-lemos@uol.com.br.
Santoro
Patricia Paula
PP
PhD in Medicine - FMUSP. Assistant Otorhinolaryngologist - Otolaryngology Ward - HCFMUSP, Head of the Dysphagia Ward - HCFMUSP.
Tavares
Raquel Aguiar
RA
Graduate Student in Otorhinolaryngology - HCFMUSP, Otorhinolaryngologist.
Garcia
Roberta Ismael Dias
RID
Graduate Student in Otorhinolaryngology - HCFMUSP, Otorhinolaryngologist.
Furia
Cristina Lemos Barbosa
CLB
PhD in Oncology - FMUSP, Speech and Hearing Therapist - Speech and Hearing Department - - HCFMUSP.
D000208:Acute Disease; D000293:Adolescent; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy; D003882:Dermatomyositis / Q000150:complications* / Q000628:therapy; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D012720:Severity of Illness Index; D013070:Speech Therapy