[Pulmonary disease in polymyositis].

Area of Science:

• Rheumatology
• Pulmonology
• Radiology

Background:

• Polymyositis and dermatomyositis are idiopathic inflammatory myopathies.
• Interstitial lung disease (ILD) is an uncommon complication, affecting approximately 10% of patients.
• Early identification of ILD is critical for managing these conditions.

Observation:

• A 75-year-old woman presented with constitutional symptoms including fever, weight loss, arthralgia, and myalgia.
• She exhibited symmetric proximal muscle weakness in both upper and lower limbs.
• Nonspecific interstitial changes were noted on her chest X-ray.

Findings:

• An exhaustive diagnostic workup led to the diagnosis of organizing pneumonia secondary to polymyositis.
• The patient's pulmonary involvement was identified despite the absence of respiratory symptoms.
• Treatment with glucocorticoids and mycophenolate resulted in positive clinical, analytical, and radiological outcomes.

Implications:

• This case highlights the significance of chest X-rays in screening for systemic diseases.
• Radiographic findings can prompt further investigation for polymyositis, even without overt respiratory complaints.
• Integrating imaging findings into the diagnostic pathway is essential for comprehensive patient care.