title: Limb edema and anasarca associated with severe dermatomyositis: report of four cases.
abstract: Dermatomyositis is an autoimmune disorder that causes proximal muscle weakness and skin changes which include generalized erythema, heliotrope rash and/or Gottron's papules. Generalized or limb edema is an uncommon manifestation of dermatomyositis. Here, we report four cases who presented with generalized or limb edema, proximal muscle weakness, erythematous skin rash and/or dysphagia. Muscle biopsy revealed perifascicular fiber atrophy, a characteristic finding of dermatomyositis. The absence of other causes indicated that the generalized or limb edema was caused by dermatomyositis. None of our patients showed significant improvement with steroids alone, and more aggressive immunotherapy eventually resolved the edema. We concluded that generalized or limb edema may be a hallmark of a severe form of dermatomyositis and requires prompt and aggressive therapies.
authors.affiliation: Wesley Neurology Clinic in Memphis, TN, USA. ychai2@uthsc.edu
authors.forename: Yaohui
authors.initials: Y
authors.lastname: Chai
authors.forename: Tulio E
authors.initials: TE
authors.lastname: Bertorini
authors.forename: Yingjun D
authors.initials: YD
authors.lastname: Li
authors.forename: Christopher
authors.initials: C
authors.lastname: Mitchell
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Guan
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003882:Dermatomyositis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004487:Edema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005076:Exanthema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005121:Extremities; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012871:Skin Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome