Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy
Identifieur interne : 001E85 ( Istex/Corpus ); précédent : 001E84; suivant : 001E86Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy
Auteurs : Hajime Kono ; Shigeko Inokuma ; Hisanori Nakayama ; Mie SuzukiSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2000-05-01.
English descriptors
- Teeft :
- Adult dermatomyositis, Biopsy, Bronchial mucosa, Bronchial necrosis, Bronchial wall, Bronchoscopy, Case reports, Cutaneous, Cutaneous vasculopathy, Daily pulse, Dermatomyositis, Fibreoptic bronchoscopy, Interstitial, Interstitial pneumonitis, Lesion, Literature review, Muscle weakness, Ndings, Necrosis, Normal value, Pneumomediastinum, Pneumonitis, Rare complication, Serum levels, Spontaneous pneumomediastinum, Steroid treatment, Subcutaneous emphysema, Subepithelial necrosis, Vasculopathy, White plaques.
Abstract
OBJECTIVES To study the pathogenesis of pneumomediastinum in polymyositis/dermatomyositis (PM/DM). PATIENTS AND METHODS The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. RESULTS Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum. CONCLUSIONS In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.
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DOI: 10.1136/ard.59.5.372
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ISTEX:966D9B5EB602E00A7288CC6F003BC330B046A9D5Le document en format XML
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last="Nakayama">Hisanori Nakayama</name><affiliation><mods:affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</mods:affiliation></affiliation></author><author><name sortKey="Suzuki, Mie" sort="Suzuki, Mie" uniqKey="Suzuki M" first="Mie" last="Suzuki">Mie Suzuki</name><affiliation><mods:affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:966D9B5EB602E00A7288CC6F003BC330B046A9D5</idno><date when="2000" year="2000">2000</date><idno type="doi">10.1136/ard.59.5.372</idno><idno type="url">https://api.istex.fr/ark:/67375/NVC-Z5K98MGT-L/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001E85</idno><idno type="wicri:explorRef" wicri:stream="Istex" 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uniqKey="Nakayama H" first="Hisanori" last="Nakayama">Hisanori Nakayama</name><affiliation><mods:affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</mods:affiliation></affiliation></author><author><name sortKey="Suzuki, Mie" sort="Suzuki, Mie" uniqKey="Suzuki M" first="Mie" last="Suzuki">Mie Suzuki</name><affiliation><mods:affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2000-05-01">2000-05-01</date><biblScope unit="volume">59</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="372">372</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Adult dermatomyositis</term><term>Biopsy</term><term>Bronchial mucosa</term><term>Bronchial necrosis</term><term>Bronchial wall</term><term>Bronchoscopy</term><term>Case reports</term><term>Cutaneous</term><term>Cutaneous vasculopathy</term><term>Daily pulse</term><term>Dermatomyositis</term><term>Fibreoptic bronchoscopy</term><term>Interstitial</term><term>Interstitial pneumonitis</term><term>Lesion</term><term>Literature review</term><term>Muscle weakness</term><term>Ndings</term><term>Necrosis</term><term>Normal value</term><term>Pneumomediastinum</term><term>Pneumonitis</term><term>Rare complication</term><term>Serum levels</term><term>Spontaneous pneumomediastinum</term><term>Steroid treatment</term><term>Subcutaneous emphysema</term><term>Subepithelial necrosis</term><term>Vasculopathy</term><term>White plaques</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">OBJECTIVES To study the pathogenesis of pneumomediastinum in polymyositis/dermatomyositis (PM/DM). PATIENTS AND METHODS The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. RESULTS Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum. CONCLUSIONS In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>pneumomediastinum</json:string><json:string>vasculopathy</json:string><json:string>dermatomyositis</json:string><json:string>cutaneous</json:string><json:string>cutaneous vasculopathy</json:string><json:string>pneumonitis</json:string><json:string>ndings</json:string><json:string>interstitial pneumonitis</json:string><json:string>bronchoscopy</json:string><json:string>bronchial wall</json:string><json:string>spontaneous pneumomediastinum</json:string><json:string>bronchial necrosis</json:string><json:string>interstitial</json:string><json:string>subcutaneous emphysema</json:string><json:string>adult dermatomyositis</json:string><json:string>normal value</json:string><json:string>literature review</json:string><json:string>subepithelial necrosis</json:string><json:string>case reports</json:string><json:string>bronchial mucosa</json:string><json:string>rare complication</json:string><json:string>white plaques</json:string><json:string>fibreoptic bronchoscopy</json:string><json:string>serum levels</json:string><json:string>steroid treatment</json:string><json:string>muscle weakness</json:string><json:string>daily pulse</json:string><json:string>lesion</json:string><json:string>necrosis</json:string><json:string>biopsy</json:string></teeft></keywords><author><json:item><name>Hajime Kono</name><affiliations><json:string>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</json:string></affiliations></json:item><json:item><name>Shigeko Inokuma</name><affiliations><json:string>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</json:string></affiliations></json:item><json:item><name>Hisanori Nakayama</name><affiliations><json:string>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</json:string></affiliations></json:item><json:item><name>Mie Suzuki</name><affiliations><json:string>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>pneumomediastinum</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dermatomyositis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cutaneous vasculopathy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>bronchial necrosis</value></json:item></subject><arkIstex>ark:/67375/NVC-Z5K98MGT-L</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>other</json:string></originalGenre><abstract>OBJECTIVES To study the pathogenesis of pneumomediastinum in polymyositis/dermatomyositis (PM/DM). PATIENTS AND METHODS The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. RESULTS Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum. CONCLUSIONS In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.</abstract><qualityIndicators><score>7.976</score><pdfWordCount>3180</pdfWordCount><pdfCharCount>21639</pdfCharCount><pdfVersion>1.1</pdfVersion><pdfPageCount>5</pdfPageCount><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>233</abstractWordCount><abstractCharCount>1641</abstractCharCount><keywordCount>4</keywordCount></qualityIndicators><title>Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy</title><pmid><json:string>10784520</json:string></pmid><genre><json:string>other</json:string></genre><host><title>Annals of the Rheumatic Diseases</title><language><json:string>unknown</json:string></language><issn><json:string>0003-4967</json:string></issn><eissn><json:string>1468-2060</json:string></eissn><publisherId><json:string>ard</json:string></publisherId><volume>59</volume><issue>5</issue><pages><first>372</first></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Muscle disease</value></json:item><json:item><value>Interstitial lung disease</value></json:item><json:item><value>Connective tissue disease</value></json:item><json:item><value>Musculoskeletal syndromes</value></json:item><json:item><value>Surgical diagnostic tests</value></json:item></subject></host><namedEntities><unitex><date><json:string>from January 1986 to December 1998</json:string><json:string>3/1/0</json:string><json:string>2000-05-01</json:string></date><geogName></geogName><orgName></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Ann Rheum</json:string><json:string>S. 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PATIENTS AND METHODS The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. RESULTS Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum. CONCLUSIONS In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>pneumomediastinum</term></item><item><term>dermatomyositis</term></item><item><term>cutaneous vasculopathy</term></item><item><term>bronchial necrosis</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Muscle disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Interstitial lung disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Connective tissue disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Musculoskeletal syndromes</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Surgical diagnostic tests</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2000-05-01">Created</change><change when="2000-05-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-Z5K98MGT-L/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="other" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">annrheumdis</journal-id><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id><journal-id journal-id-type="publisher-id">ard</journal-id><journal-title>Annals of the Rheumatic Diseases</journal-title><abbrev-journal-title abbrev-type="publisher">Ann Rheum Dis</abbrev-journal-title><abbrev-journal-title>Ann Rheum Dis</abbrev-journal-title><issn pub-type="ppub">0003-4967</issn><issn pub-type="epub">1468-2060</issn><publisher><publisher-name>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher-name></publisher></journal-meta><article-meta><article-id>99316</article-id><article-id pub-id-type="other">annrheumdis;59/5/372</article-id><article-id pub-id-type="doi">10.1136/ard.59.5.372</article-id><article-id pub-id-type="pmid">10784520</article-id><article-id pub-id-type="other">372</article-id><article-id pub-id-type="other">ard.59.5.372</article-id><article-categories><subj-group subj-group-type="heading"><subject>Extended report</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Muscle disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Interstitial lung disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Connective tissue disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Musculoskeletal syndromes</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Surgical diagnostic tests</subject></subj-group></article-categories><title-group><article-title>Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kono</surname><given-names>Hajime</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Inokuma</surname><given-names>Shigeko</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Nakayama</surname><given-names>Hisanori</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Suzuki</surname><given-names>Mie</given-names></name></contrib></contrib-group><aff id="aff1">Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</aff><author-notes><corresp>Dr Inokuma Email:<email xlink:type="simple">inokuma-k@komagomehospital.bunkyo.tokyo.jp</email></corresp></author-notes><pub-date pub-type="ppub"><day>1</day><month>5</month><year>2000</year></pub-date><pub-date pub-type="epub"><day>1</day><month>5</month><year>2000</year></pub-date><volume>59</volume><volume-id pub-id-type="other">59</volume-id><volume-id pub-id-type="other">59</volume-id><issue>5</issue><issue-id pub-id-type="other">annrheumdis;59/5</issue-id><issue-id pub-id-type="other">5</issue-id><issue-id pub-id-type="other">59/5</issue-id><fpage>372</fpage><history><date date-type="accepted"><day>2</day><month>11</month><year>1999</year></date></history><permissions><copyright-statement>Annals of the Rheumatic Diseases</copyright-statement><copyright-year>2000</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="annrheumdis-59-372.pdf"></self-uri><abstract><sec><title>OBJECTIVES</title><p>To study the pathogenesis of pneumomediastinum in polymyositis/dermatomyositis (PM/DM).</p></sec><sec><title>PATIENTS AND METHODS</title><p>The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed.</p></sec><sec><title>RESULTS</title><p>Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum.</p></sec><sec><title>CONCLUSIONS</title><p>In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.</p></sec></abstract><kwd-group><kwd>pneumomediastinum</kwd><kwd>dermatomyositis</kwd><kwd>cutaneous vasculopathy</kwd><kwd>bronchial necrosis</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy</title></titleInfo><name type="personal"><namePart type="given">Hajime</namePart><namePart type="family">Kono</namePart><affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shigeko</namePart><namePart type="family">Inokuma</namePart><affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hisanori</namePart><namePart type="family">Nakayama</namePart><affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mie</namePart><namePart type="family">Suzuki</namePart><affiliation>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-7474895G-0">other</genre><originInfo><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><dateIssued encoding="w3cdtf">2000-05-01</dateIssued><dateCreated encoding="w3cdtf">2000-05-01</dateCreated><copyrightDate encoding="w3cdtf">2000</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>OBJECTIVES To study the pathogenesis of pneumomediastinum in polymyositis/dermatomyositis (PM/DM). PATIENTS AND METHODS The clinical records of 48 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum and cutaneous vasculopathy, and the chest radiographic changes. A patient with pneumomediastinum with a characteristic change in his bronchus is described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. RESULTS Among the 48 patients with PM/DM, pneumomediastinum was observed as a complication in four patients with DM and none of the patients with PM. Three of the four patients with pneumomediastinum, but only six of the 44 patients without this complication, had associated cutaneous vasculopathy. There was a significant association of pneumomediastinum with cutaneous vasculopathy (p = 0.02) and younger age (p = 0.04), but not with the prevalence of lung disease. A 30 year old man (patient 1) with DM, who had interstitial pneumonitis and skin ulceration due to vasculopathy, developed pneumomediastinum. Fibreoptic bronchoscopy showed white plaques on the bronchial mucosa, which were confirmed by microscopic examination as representing subepithelial necrosis. A literature review showed 13 cases of DM but no patient with PM with pneumomediastinum. CONCLUSIONS In patient 1, bronchial necrosis due to vasculopathy was strongly suspected as being responsible for the pneumomediastinum. The results suggest that pneumomediastinum was associated not with interstitial pneumonitis but with the complication of vasculopathy appearing as skin lesions in DM.</abstract><subject><genre>keywords</genre><topic>pneumomediastinum</topic><topic>dermatomyositis</topic><topic>cutaneous vasculopathy</topic><topic>bronchial necrosis</topic></subject><relatedItem type="host"><titleInfo><title>Annals of the Rheumatic Diseases</title></titleInfo><titleInfo type="abbreviated"><title>Ann Rheum Dis</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>hwp-journal-coll</genre><topic>Muscle disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Interstitial lung disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Connective tissue disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Musculoskeletal syndromes</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Surgical diagnostic tests</topic></subject><identifier type="ISSN">0003-4967</identifier><identifier type="eISSN">1468-2060</identifier><identifier type="PublisherID">ard</identifier><identifier type="PublisherID-hwp">annrheumdis</identifier><identifier type="PublisherID-nlm-ta">Ann Rheum Dis</identifier><part><date>2000</date><detail type="volume"><caption>vol.</caption><number>59</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>372</start></extent></part></relatedItem><identifier type="istex">966D9B5EB602E00A7288CC6F003BC330B046A9D5</identifier><identifier type="ark">ark:/67375/NVC-Z5K98MGT-L</identifier><identifier type="DOI">10.1136/ard.59.5.372</identifier><identifier type="href">annrheumdis-59-372.pdf</identifier><identifier type="PMID">10784520</identifier><identifier type="local">annrheumdis;59/5/372</identifier><accessCondition type="use and reproduction" contentType="copyright">Annals of the Rheumatic Diseases</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>Annals of the Rheumatic Diseases</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-Z5K98MGT-L/record.json</uri></json:item></metadata><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-Z5K98MGT-L/annexes.jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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