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Dermatomyositis with massive ascites.

Seisuke Ota1, Akinori Kasahara, Taku Yamada

  • 1Department of Internal Medicine, The Himeji St. Mary's Hospital, Himeji, Japan. seisukeota@mail.goo.ne.jp

Rheumatology International
|February 9, 2007
PubMed
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Dermatomyositis, a rare autoimmune disorder, can cause exudative ascites. This case highlights a 63-year-old man with fatigue and abdominal distension, ultimately diagnosed with dermatomyositis-induced ascites.

Area of Science:

  • Rheumatology
  • Gastroenterology
  • Neurology

Background:

  • Dermatomyositis is an idiopathic inflammatory myopathy characterized by muscle weakness and characteristic skin rashes.
  • Ascites, the accumulation of fluid in the peritoneal cavity, is uncommon in dermatomyositis, with few documented cases.

Observation:

  • A 63-year-old male presented with generalized fatigue and significant abdominal enlargement (gastromegaly).
  • Physical examination revealed abdominal distension without tenderness.
  • Laboratory tests showed elevated serum myogenic enzymes and electromyography confirmed a muscle disorder.

Findings:

  • Abdominal paracentesis yielded 2,500 ml of clear, serous fluid classified as exudate based on specific gravity, positive Rivalta reaction, and high protein content.

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  • Differential diagnosis excluded other common causes of exudative ascites.

    • Implications:

    • This case underscores dermatomyositis as a potential, albeit rare, cause of exudative ascites.
    • Early recognition and diagnosis of dermatomyositis-induced ascites are crucial for appropriate management.
    • Further research into the mechanisms linking dermatomyositis to serous fluid accumulation is warranted.