Journal Information
Vol. 16. Issue 4.
Pages 671-677 (July - August 2010)
Share
Share
Download PDF
More article options
Vol. 16. Issue 4.
Pages 671-677 (July - August 2010)
Caso Clínico/Case Report
Open Access
Envolvimento pulmonar na polimiosite
Pulmonary disease in polymyositis
Visits
8079
Direndra Hasmucrai1, Ana Cristina Mendes2, Isabel Correia2, Teresinha Evangelista3,*, António Bugalho de Almeida4
1 Interno do complementar de Pneumologia
2 Assistente Hospitalar Graduada de Pneumologia
3 Assistente Hospitalar de Neurologia
4 Director de Serviço de Pneumologia I
This item has received

Under a Creative Commons license
Article information
Resumo

Introdução: A polimiosite (PM) e a dermatomiosite são classificadas como miopatias inflamatórias idiopáticas. O envolvimento pulmonar por PM é pouco frequente, estando descrito na literatura em cerca de 10% de casos.

Os autores apresentam um caso de uma mulher de 75 anos, com queixas de febre, perda ponderal, artralgias, mialgias e diminuição simétrica e proximal da força muscular com impotência funcional dos membros superiores e inferiores, com início um mês antes do internamento. Apresentava infiltrados pulmonares na telerradiografia de tórax. Após estudo exaustivo estabeleceu-se o diagnóstico de envolvimento pulmonar na forma de pneumonia organizativa por PM. Efectuou-se corticoterapia e terapêutica com micofenolato com melhoria clínica, analítica e radiológica.

Conclusão: Neste caso, foi a alteração na telerradiografia de tórax numa doente sem sintomatologia respiratória que levou ao estudo exaustivo até ao diagnóstico de PM, realçando mais uma vez a importância da telerradiografia no rastreio de patologias de outros foros.

Rev Port Pneumol 2010; XVI (4): 671-677

Palavras-chave:
Polimiosite
telerradiografia do tórax
diagnóstico
prognóstico
Abstract

Introduction: Polymyositis and dermatomyositis are classified as idiopathic inflammatory myopathies. Interstitial lung disease is rare and is described in the literature in about 10% of cases.

The authors describes a case of 75 year old woman presenting with one month evolution of fever, weight loss, arthralgia, myalgia and symmetric and proximal muscle weakness of upper and lower limbs. Nonspecific interstitial changes was found in chest X-ray. After exhaustive study, the diagnosis of pulmonary envolvement in the form of organizing pneumonia by polymyositis, was established. Glucocorticoids and mycophenolate were prescribed with good clinical, analytical and radiological outcome.

Conclusion: In this case, it was the changes in the chest X-ray in a patient without respiratory sym ptomatology, that conducted to exhaustive study to polymyositis diagnosis, enhancing once again the importance of X-ray in the screaning of pathologies of other systems.

Rev Port Pneumol 2010; XVI (4): 671-677

Key-words:
Polymyositis
chest X-ray
diagnosis
prognosis
Full text is only aviable in PDF
Bibliografia
[1.]
L.M. Marc, A.R. Stacy.
Initial treatment of dermatomyositis and polymyositis in adults, (2008),
[2.]
L.M. Marc.
Clinical manifestations and diagnosis of adult dermatomyositis and polymyositis, (2008),
[3.]
L.M. Marc.
Pulmonary disease in dermatomyositis and polymyositis, (2008),
[4.]
Clinical immunology.
Online, (2008),
[5.]
T.W. Bunch, J.W. Worthington, J.J. Combs, et al.
Azathioprine with prednisone for polymyositis.
Ann Intern Med, 92 (1980), pp. 265
[6.]
Y. Troyanov, I.N. Targoff, J.L. Tremblay, et al.
Novel classification of idiopathic inflammatory myopathies besedon overlap syndrome features and autoantibodies: analysis of 100 French Canadian patients.
Medicine (Baltimore), 84 (2005), pp. 231
[7.]
D.A. Isenberg, E. Allen, V. Farewell, et al.
International consensus outcome measures for patients with idiopathic anflammatory myopathies. Development and initial validation of myositis activity and damage indices in patients with adult onset disease.
Rheumatology (Oxford), 43 (2004), pp. 49
[8.]
L.A. Love, R.L. Left, D.D. Fraser, et al.
A new approch to the classification of idiopathic inflammatory myopathy: Myositis-specific autoantibodies define useful homogeneous patient groups.
Medicine, 70 (1991), pp. 360
[9.]
Y. Nanbu, M. Mouri, H. Toga, et al.
Gender and underlying disease affect the frequency of the concurrence of adult polymyositis/dermatomyositis and interstitial pneumonia.
Chest, 106 (1994), pp. 1931
[10.]
I. Marie, E. Hachulla, P. Cherin, et al.
Interstitial lung disease in polymyositis and dermatomyositis.
Arthritis Rheum, 47 (2002), pp. 614
Copyright © 2010. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?