Dermatomyositis complicated with hemorrhagic shock of the iliopsoas muscle on both sides and the thigh muscle.
A 65-year-old Japanese woman, diagnosed with dermatomyositis with myopathy and characteristic skin lesion, was intravenously administered methylprednisolone 500 mg per day for 3 days, followed by prednisolone 60 mg po per day. Four days later, she went into shock. Computed tomography of the abdomen showed hematoma in the iliopsoas muscle on both sides and a thigh muscle. Intravenously administered heparin was stopped, and 4 U of packed cells and 4 U of fresh frozen plasma were transfused. The patient subsequently developed pulmonary edema requiring assisted ventilation, and made a successful recovery, returning home after a short period of intensive rehabilitation.
Miwa
Yusuke
Y
Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. y.miwa@mbf.ocn.ne.jp
Muramatsu
Mizuho
M
Takahashi
Ryo
R
Wakabayashi
Kuninobu
K
Odai
Tsuyoshi
T
Isozaki
Takeo
T
Yajima
Nobuyuki
N
Kasama
Tsuyoshi
T
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016658:Psoas Muscles / Q000098:blood supply / Q000000981:diagnostic imaging*; D012771:Shock, Hemorrhagic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*; D013848:Thigh / Q000098:blood supply / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D007166:Immunosuppressive Agents