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Dermatomyositis Presenting as Life-threatening Hypercalcemia

Journal of Rheumatic Diseases 2020년 27권 4호 p.285 ~ 289
Chiu Harold Henrison C., Remalante Patricia Pauline, Nacianceno Patricia, Velasco Rogelio Jr., Larrazabal Ramon Jr., Zamora Geraldine,
소속 상세정보
 ( Chiu Harold Henrison C. ) - University of Philippines Manila Philippine General Hospital Department of Medicine
 ( Remalante Patricia Pauline ) - University of Philippines Manila Philippine General Hospital Department of Medicine
 ( Nacianceno Patricia ) - University of Philippines Manila Philippine General Hospital Department of Dermatology
 ( Velasco Rogelio Jr. ) - University of Philippines Manila Philippine General Hospital Department of Medicine
 ( Larrazabal Ramon Jr. ) - University of Philippines Manila Philippine General Hospital Department of Medicine
 ( Zamora Geraldine ) - University of Philippines Manila Philippine General Hospital Department of Medicine

Abstract


Dermatomyositis is a rare disease characterized by classic skin lesions and muscle weakness. In rare cases, life-threatening hypercalcemia may develop caused by regression of dystrophic calcifications. Here we report a 36-year-old man who presented with progressive proximal weakness, difficulty in ambulation, and weight loss. He had the V-sign, Gottron’s papules, and hard, chalky nodules on both antecubital, thigh, and hip areas. Laboratory examinations revealed hypercalcemia (3.47 mmol/L) and shortened QT interval. Workup for malignancy and tuberculosis yielded negative results. Biopsy of the antecubital areas revealed calcinosis cutis. Serum calcium levels gradually normalized with hydration and steroids. Our case illustrated that a high index of suspicion for dermatomyositis is warranted for early diagnosis and ascertaining the etiology of hypercalcemia is vital in the management of this life-threatening complication. While hypercalcemia from dermatomyositis may respond to steroids, to date, individualization of treatment remains the standard of care.

키워드

Dermatomyositis; Hypercalcemia; Calcinosis

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