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A case report of life-threatening acute dysphagia in dermatomyositis: Challenges in diagnosis and treatment.

Abstract Although dysphagia is a known complication of dermatomyositis, sudden onset of dysphagia without the notable aggravation of other symptoms can make the diagnosis and treatment challenging.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29703016
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180516
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 17
DP  - 2018 Apr
TI  - A case report of life-threatening acute dysphagia in dermatomyositis: Challenges 
      in diagnosis and treatment.
PG  - e0508
LID - 10.1097/MD.0000000000010508 [doi]
AB  - RATIONALE: Although dysphagia is a known complication of dermatomyositis, sudden 
      onset of dysphagia without the notable aggravation of other symptoms can make the
      diagnosis and treatment challenging. PATIENT CONCERNS: A 53-year-old male
      diagnosed as dermatomyositis 1 month ago came to our emergency department
      complaining of a sudden inability to swallow solid foods and liquids. The patient
      showed generalized edema, but the muscle power was not different compared with 1 
      month ago. DIAGNOSES: Serum creatine kinase level was lower than that measured 2 
      weeks ago. Computed tomography scan of the larynx, chest, abdomen, and pelvis, an
      esophagogastroduodenoscopy, and brain magnetic resonance imaging were
      unremarkable. A videofluoroscopic swallowing study revealed inadequate pharyngeal
      contraction and slightly decreased upper esophageal sphincter opening with silent
      aspiration. INTERVENTION: Treatment with oral prednisolone, intravenous
      methylprednisolone, azathioprine, and intravenous immunoglobulins was applied.
      During the course of medical treatment for life-threatening dysphagia, he
      continued with rehabilitative therapy. OUTCOMES: He could swallow saliva at 2
      months and showed normal swallowing function at 3 months from the onset of
      dysphagia. Dysphagia has not recurred for 3 years after recovery. LESSONS: A
      multidisciplinary approach is necessary to diagnose severe acute dysphagia due to
      exacerbation of underlying dermatomyositis rather than other structural or
      neurological causes. Appropriate supportive care is important because dysphagia
      can be life-threatening and last for a long time.
FAU - Kwon, Kyoung Min
AU  - Kwon KM
AD  - Department of Rehabilitation Medicine, College of Medicine, The Catholic
      University of Korea, Seoul, Republic of Korea.
FAU - Lee, Jung Soo
AU  - Lee JS
FAU - Kim, Yeo Hyung
AU  - Kim YH
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - AIM
SB  - IM
MH  - Deglutition Disorders/drug therapy/*etiology/rehabilitation
MH  - Dermatomyositis/*complications
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Male
MH  - Methylprednisolone/therapeutic use
MH  - Middle Aged
MH  - Prednisolone/therapeutic use
PMC - PMC5944494
EDAT- 2018/04/29 06:00
MHDA- 2018/05/15 06:00
CRDT- 2018/04/29 06:00
PHST- 2018/04/29 06:00 [entrez]
PHST- 2018/04/29 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
AID - 10.1097/MD.0000000000010508 [doi]
AID - 00005792-201804270-00048 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(17):e0508. doi: 10.1097/MD.0000000000010508.