Dermatomyositis-related intestinal dysmotility
Christine Loftis1, Rosa White1, Emilia C Dulgheru2
1Internal Medicine Department- Doctors Hospital at Renaissance, University of Texas at Rio Grande Valley, Edinburg, TX, USA.
Modern Rheumatology Case Reports
|November 18, 2021
Summary
Dermatomyositis (DM) can cause rare but serious gastrointestinal issues like constipation and rectal bleeding. Early recognition of these complications is crucial for managing patient outcomes in inflammatory myopathy.
Area of Science:
- Rheumatology
- Gastroenterology
- Dermatology
Background:
- Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) characterized by muscle weakness and skin manifestations.
- While dysphagia is a common symptom, lower gastrointestinal (GI) complications are rarely reported in DM patients.
Observation:
- A 69-year-old woman with newly diagnosed DM presented with worsening dysphagia and constipation.
- Physical exam revealed characteristic DM skin lesions and proximal muscle weakness.
- During hospitalization, she developed pulmonary embolism and rectal bleeding, with colonoscopy revealing a stercoral ulcer.
Findings:
- Laboratory results showed partially treated acquired IIM with perifascicular atrophy.
- The patient's rectal bleeding was attributed to a stercoral ulcer secondary to chronic constipation, a rare GI manifestation of DM.
- Pulmonary embolism was also identified and treated during her hospital stay.
Implications:
- This case underscores the importance of considering rare GI complications in DM patients.
- Recognizing and managing these complications is vital for improving morbidity and mortality in dermatomyositis.
- Further research into the pathogenesis and management of GI involvement in DM is warranted.
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