Dermatomyositis Developing in the first Trimester of Pregnancy

Park, In-Whee;Suh, Yu-Jin;Han, Jae-Ho;Shin, Yoo-Seob;Choi, Jeong-Hee;Park, Hae-Sim;Suh, Chang-Hee

  • 발행 : 20030000

초록

Dermatomyositis in pregnancy is rare. Pregnancy may be a precipitating factor at the onset or may develop during the course of dermatomyositis, which would exacerbate disease activity. In this study, we report a 22-year-old female patient who developed generalized skin rash and progressive muscle weakness in the twelfth week of pregnancy. She was diagnosed with dermatomyositis and underwent therapeutic abortion, due to the high fetal mortality rate of the disease when developed in the first trimester. Her symptoms improved with treatment of intravenous immunoglobulin and a high dose of corticosteroids.

키워드

참고문헌

  1. Banker BQ, Engel AG. The polymyositis and dermatomyositis syndromes. In: Engel AG, Banker BQ, eds. Myology. 1st eds. New York: McGraw-HilI, 1385-1422, 1986.
  2. Pinheiro Gda R, Goldenberg J, Atra E, Pereira RB, Camano L, Schmidt B. Juvenile dermatomyositis and pregnancy. Report and literature review. J Rheumatol 19:1798-1801, 1992.
  3. Kofteridis DP, Malliotakis PI, Sotsiou F, Vardakis NK, Vamvakas LN, Emmanouel DS. Acute onset of dermatomyositis presenting in pregnancy with rhabdomyolysis and fetal loss. Scand J Rheumatol 28:192-194, 1999. https://doi.org/10.1080/03009749950154301
  4. Dalakas MC. Polymyositis, dermatomyositis, and inclusion-body myositis. N Engl J Med 325:1487-1498, 1991.
  5. Tymms KE, Webb J. Dermatopolymyositis and other connective tissue diseases: A review of 105 cases. J Rheumatol 12:1140-1148, 1985.
  6. Ishii N, Ono H, Kawaguchi T, Nakajima H. Dermatomyositis and pregnancy. Case report and review of the literature. Dermatologica 183:146-149, 1991. https://doi.org/10.1159/000247657
  7. Kanoh H, Izumi T, Seishima M, Nojiri M, Ichiki Y, Kitajima Y. A case of dermatomyositis that developed after delivery: the involvement of pregnancy in the induction of dermatomyositis. Br J Dermatol 141:897-900, 1999. https://doi.org/10.1046/j.1365-2133.1999.03165.x
  8. Johnson MJ. Obstetric complications and rheumatic disease. Rheum Dis Clin North Am 23:169-182, 1997. https://doi.org/10.1016/S0889-857X(05)70321-5
  9. Gutierrez G, Dagnino R, Mintz G. Polymyositis/dermatomyositis and pregnancy. Arthritis Rheum 27:291-294, 1984. https://doi.org/10.1002/art.1780270307
  10. Dalakas MC. Immunopathogenesis of inflammatory myopathies. Ann Neurol 37 (suppl):74-86, 1995.
  11. Basta M, Kirshbom P, Frank MM, Fires LF. Mechanisms of therapeutic effect of high-dose intravenous immunoglobulin. J Clin Invest 84:1974-1981, 1989. https://doi.org/10.1172/JCI114387
  12. Dalakas MG, Ilia I, Dambrosia JM, Soueidan SA, Stein DP, Otero C. A controlled trial of high-dose intravenous immunoglobulin infusion as treatment of dermatomyositis. N Engl J Med 329:1993-2000, 1993. https://doi.org/10.1056/NEJM199312303292704
  13. Dalakas MG. Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: Present status and practical therapeutic guidelines. Muscle Nerve 22:1479-1497, 1999. https://doi.org/10.1002/(SICI)1097-4598(199911)22:11<1479::AID-MUS3>3.0.CO;2-B