Un caso de compromiso cutáneo severo en la clínica inicial presentación de dermatomiositis juvenil
Palabras clave:
dermatomiositis juvenil, presentación inicial
Resumen
La dermatomiositis juvenil es una colagenopatía que afecta a niños y adolescentes, principalmente entre las edades de 4 y 16 años. Sus principales manifestaciones clínicas son la debilidad simétrica de músculos proximales, enzimas musculares elevadas y la presencia de lesiones cutáneas, como el heliotropo y las pápulas de gottron. Aquí describimos un caso de dermatomiositis juvenil con un inicio precoz a los 18 meses de edad, presentando lesions cutáneas ulcerativas severas y vasculopatía probablemente debido a la afectación gastrointestinal, que requirió tratamiento inmediato con inmunosupresores.Citas
I. Okongo Lo, Esser M, Wilmshurst J, Scott C. Characteristics and outcome of children with juvenile dermatomyositis in Cape Town: a cross-sectional study. Pediatric Rheumatology 2016; 14:60.
II. Kim S, Kahn P, Robinso AB, Lang B, Shulman A, Oberle EJ. Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease. Pediatric Rheumatology 2017; 15:21.
III. Almeida S, Braga M, Santos MJ. Juvenile dermatomyositis with anti-signal recognition particle antibodies: a case report. ACTA REuMAToL PoRT. 2016;41:162-164.
IV. Bernatsky S, Smargiassi A, Barnabe C et al. Fine particulate air pollution and systemic autoimmune rheumatic disease in two Canadian provinces. Environ Res. 2016;146:85-91.
V. Orione MAM, Silva CA, Sallum AME et al. Risk Factors for Juvenile Dermatomyositis: Exposure to Tobacco and Air Pollutants During Pregnancy Arthritis Care & Research. 2014; 66:1571-1575.
VI. Neto NSR, Schainberg Cg. Dermatomiosite juvenil: revisão e atualização em patogênese e tratamento. Rev Bras Reumatol 2010;50:299-312.
VII. Muro Y, Sugiura K, Akiyama M. Cutaneous manifestations in dermatomyositis: Key Clinical and seroloical features – a comprehensive review. Clinic ver Allerg Immunol 2016; 51:293-302.
VIII. Feldman BM, Rider Lg, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet 2008; 371: 2201-2212.
IX. Khuder SA, Peshimam AZ, Agraharam S. Environmental risk factors for rheumatoid arthritis. Rev Environ Health. 2002; 17:307-315.
X. Gold LS, Ward MH, Dosemeci M, De Roos AJ. Systemic autoimmune disease mortality and occupational exposures. Arthritis Rheum. 2007; 56:3189-3201.
XI. Parks gC, De Roos AJ. Pesticides, chemical and industrial exposures in relation to systemic lupus erythematosus. Lupus. 2014; 23: 527-536.
XII. Crowe WE, Bove KE, Levinson JE, Hilton PK. Clinical and pathogenetic implications of histopathology in childhood polydermatomyositis. Arthritis Rheum 1982; 25: 126-139.
XIII. Spencer CH, Hanson v, Singsen BH, Bernstein BH, Kornreich HK, King KK. Course of treated juvenile dermatomyositis. J Pediatr 1984; 105: 399-408.
XIV. Tezak Z, Hoff man EP, Lutz JL, Tezak Z, Hoff man EP, Lutz JL, et al. gene expression profi ling in DQA1*0501 children with untreated dermatomyositis: a novel model of pathogenesis. J Immunol 2002; 168: 4154-4163.
XV. Baechler EC, Bauer JW, Slattery CA et al. An interferon signature in the peripheral blood of dermatomyositis patients is associated with disease activity. Mol Med 2007; 13: 59-68.
XVI. Gitiaux C, Antonio M, Aouizerate J, gherardi RK, Guilbert T, Barnerias C. vasculopathy-related clinical and pathological features are associated with severe juvenile dermatomyositis. Rheumatology 2016; 55:470-479.
XVII. Ravelli A, Trail L, Ferrari C et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients.
Arthritis Care Res 2010;62:63-72.
XVIII. Robinson AB, Hoeltzel MF, Wahezi DM et al. Clinical characteristics of children with juvenile dermatomyositis:the Childhood Arthritis and Rheumatology Research Alliance Registry. Arthritis Care Res 2014;66:404-10.
XIX. Mamyrova g, Kleiner DE, James-Newton L, Shaham B, Miller FW, Rider Lg. Late-onset gastrointestinal pain in juvenile dermatomyositis as a manifestation of ischemic ulceration from chronic endarteropathy. Arthritis Rheum 2007;57:881-4.
XX. McCann LJ, Juggins AD, Maillard SM et al. The Juvenile Dermatomyositis National Registry and Repository (UK and Ireland): clinical characteristics of children recruited within the first 5 yr. Rheumatology (oxford). 2006; 45:1255-1260.
XXI. Guseinova D, Consolaro A, Trail L et al. Comparison of clinical features and drug therapies among European and Latin American patients with juvenile dermatomyositis. Clin Exp Rheumatol. 2011; 29:117-124.
XXII. Enders FB, BaderMeunier B, Baildam E et al. Consensusbased recommendations for the management of juvenile dermatomyositis Ann Rheum Dis 2017;76:329-340.
XXIII. Ruperto N, Pistorio A, oliveira S, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new-onset juvenile dermatomyositis: a randomised trial. Lancet 2016;387:671-8.
XXIV. Riley P, Maillard SM, Wedderburn LR, Woo P, Murray KJ, Pilkington CA. Intravenous cyclophosphamide pulse therapy in juvenile dermatomyositis. A review of efficacy and safety. Rheumatology 2004; 43: 491-96.
XXV. Stringera E and Feldman BM. Advances in the treatment of juvenile dermatomyositis. Current opinion in Rheumatology 2006, 18:503-506.
XXVI. Wedderburn LR, varsani H, Li CKC, et al. International consensus on a proposed score system for muscle biopsy evaluation in patients with JDM, for potential use in clinical trials. Arthritis Rheum 2007;57:1192-1201.
II. Kim S, Kahn P, Robinso AB, Lang B, Shulman A, Oberle EJ. Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease. Pediatric Rheumatology 2017; 15:21.
III. Almeida S, Braga M, Santos MJ. Juvenile dermatomyositis with anti-signal recognition particle antibodies: a case report. ACTA REuMAToL PoRT. 2016;41:162-164.
IV. Bernatsky S, Smargiassi A, Barnabe C et al. Fine particulate air pollution and systemic autoimmune rheumatic disease in two Canadian provinces. Environ Res. 2016;146:85-91.
V. Orione MAM, Silva CA, Sallum AME et al. Risk Factors for Juvenile Dermatomyositis: Exposure to Tobacco and Air Pollutants During Pregnancy Arthritis Care & Research. 2014; 66:1571-1575.
VI. Neto NSR, Schainberg Cg. Dermatomiosite juvenil: revisão e atualização em patogênese e tratamento. Rev Bras Reumatol 2010;50:299-312.
VII. Muro Y, Sugiura K, Akiyama M. Cutaneous manifestations in dermatomyositis: Key Clinical and seroloical features – a comprehensive review. Clinic ver Allerg Immunol 2016; 51:293-302.
VIII. Feldman BM, Rider Lg, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet 2008; 371: 2201-2212.
IX. Khuder SA, Peshimam AZ, Agraharam S. Environmental risk factors for rheumatoid arthritis. Rev Environ Health. 2002; 17:307-315.
X. Gold LS, Ward MH, Dosemeci M, De Roos AJ. Systemic autoimmune disease mortality and occupational exposures. Arthritis Rheum. 2007; 56:3189-3201.
XI. Parks gC, De Roos AJ. Pesticides, chemical and industrial exposures in relation to systemic lupus erythematosus. Lupus. 2014; 23: 527-536.
XII. Crowe WE, Bove KE, Levinson JE, Hilton PK. Clinical and pathogenetic implications of histopathology in childhood polydermatomyositis. Arthritis Rheum 1982; 25: 126-139.
XIII. Spencer CH, Hanson v, Singsen BH, Bernstein BH, Kornreich HK, King KK. Course of treated juvenile dermatomyositis. J Pediatr 1984; 105: 399-408.
XIV. Tezak Z, Hoff man EP, Lutz JL, Tezak Z, Hoff man EP, Lutz JL, et al. gene expression profi ling in DQA1*0501 children with untreated dermatomyositis: a novel model of pathogenesis. J Immunol 2002; 168: 4154-4163.
XV. Baechler EC, Bauer JW, Slattery CA et al. An interferon signature in the peripheral blood of dermatomyositis patients is associated with disease activity. Mol Med 2007; 13: 59-68.
XVI. Gitiaux C, Antonio M, Aouizerate J, gherardi RK, Guilbert T, Barnerias C. vasculopathy-related clinical and pathological features are associated with severe juvenile dermatomyositis. Rheumatology 2016; 55:470-479.
XVII. Ravelli A, Trail L, Ferrari C et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients.
Arthritis Care Res 2010;62:63-72.
XVIII. Robinson AB, Hoeltzel MF, Wahezi DM et al. Clinical characteristics of children with juvenile dermatomyositis:the Childhood Arthritis and Rheumatology Research Alliance Registry. Arthritis Care Res 2014;66:404-10.
XIX. Mamyrova g, Kleiner DE, James-Newton L, Shaham B, Miller FW, Rider Lg. Late-onset gastrointestinal pain in juvenile dermatomyositis as a manifestation of ischemic ulceration from chronic endarteropathy. Arthritis Rheum 2007;57:881-4.
XX. McCann LJ, Juggins AD, Maillard SM et al. The Juvenile Dermatomyositis National Registry and Repository (UK and Ireland): clinical characteristics of children recruited within the first 5 yr. Rheumatology (oxford). 2006; 45:1255-1260.
XXI. Guseinova D, Consolaro A, Trail L et al. Comparison of clinical features and drug therapies among European and Latin American patients with juvenile dermatomyositis. Clin Exp Rheumatol. 2011; 29:117-124.
XXII. Enders FB, BaderMeunier B, Baildam E et al. Consensusbased recommendations for the management of juvenile dermatomyositis Ann Rheum Dis 2017;76:329-340.
XXIII. Ruperto N, Pistorio A, oliveira S, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new-onset juvenile dermatomyositis: a randomised trial. Lancet 2016;387:671-8.
XXIV. Riley P, Maillard SM, Wedderburn LR, Woo P, Murray KJ, Pilkington CA. Intravenous cyclophosphamide pulse therapy in juvenile dermatomyositis. A review of efficacy and safety. Rheumatology 2004; 43: 491-96.
XXV. Stringera E and Feldman BM. Advances in the treatment of juvenile dermatomyositis. Current opinion in Rheumatology 2006, 18:503-506.
XXVI. Wedderburn LR, varsani H, Li CKC, et al. International consensus on a proposed score system for muscle biopsy evaluation in patients with JDM, for potential use in clinical trials. Arthritis Rheum 2007;57:1192-1201.
Publicado
2015-09-01
Cómo citar
1.
Martins Vicente Robazzi TC. Un caso de compromiso cutáneo severo en la clínica inicial presentación de dermatomiositis juvenil . Rev. Argent. Reumatol. [Internet]. 1 de septiembre de 2015 [citado 23 de abril de 2024];26(3):33 -7. Disponible en: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/638
Sección
Caso Clínico
Derechos de autor 2015 A nombre de los autores. Derechos de reproducción: Sociedad Argentina de Reumatología
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
