Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy
Identifieur interne : 002510 ( Main/Exploration ); précédent : 002509; suivant : 002511Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy
Auteurs : Hajime Kono [Japon] ; Shigeko Inokuma [Japon] ; Hisanori Nakayama [Japon] ; Mie Suzuki [Japon]Source :
- 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.
Url:
DOI: 10.1136/ard.59.5.372
Affiliations:
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wicri:level="1"><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Inokuma, Shigeko" sort="Inokuma, Shigeko" uniqKey="Inokuma S" first="Shigeko" last="Inokuma">Shigeko Inokuma</name><affiliation wicri:level="1"><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Nakayama, Hisanori" sort="Nakayama, Hisanori" uniqKey="Nakayama H" first="Hisanori" last="Nakayama">Hisanori Nakayama</name><affiliation wicri:level="1"><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Suzuki, Mie" sort="Suzuki, Mie" uniqKey="Suzuki M" first="Mie" last="Suzuki">Mie Suzuki</name><affiliation wicri:level="1"><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyo-ku, Tokyo 113–8677</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></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><affiliations><list><country><li>Japon</li></country><region><li>Région de Kantō</li></region><settlement><li>Tokyo</li></settlement></list><tree><country name="Japon"><region name="Région de Kantō"><name sortKey="Kono, Hajime" sort="Kono, Hajime" uniqKey="Kono H" first="Hajime" last="Kono">Hajime Kono</name></region><name sortKey="Inokuma, Shigeko" sort="Inokuma, Shigeko" uniqKey="Inokuma S" first="Shigeko" last="Inokuma">Shigeko Inokuma</name><name sortKey="Nakayama, Hisanori" sort="Nakayama, Hisanori" uniqKey="Nakayama H" first="Hisanori" last="Nakayama">Hisanori Nakayama</name><name sortKey="Suzuki, Mie" sort="Suzuki, Mie" uniqKey="Suzuki M" first="Mie" last="Suzuki">Mie Suzuki</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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