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Case Report: A Rare But Severe Complication of Dermatomyositis

Akrithi Udupa, MD, Paul McIntosh, MD, Thomas J. Cummings, MD, & Lisa Criscione-Schreiber, MD, Med  |  Issue: May 2021  |  May 13, 2021


Akrithi Udupa, MD, is a fellow in training in the Division of Rheumatology & Immunology at Duke University Hospital, Durham, N.C.

Paul McIntosh, MD, is a chief resident in the Department of Neurology at Duke University Hospital, Durham, N.C.

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Thomas J. Cummings, MD, is a pathologist at Duke University Hospital, Durham, N.C.

Lisa Criscione-Schreiber, MD, MEd, is an associate professor of medicine, rheumatology program director and vice chair for education, Department of Medicine, Duke University School of Medicine, Durham, N.C.

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References

  1. Lundberg IE. Chapter 157: Etiology and pathogenesis of inflammatory muscle disease (Myositis). In: Hochberg MC, Gravallese EM, Silman AJ, et al. Rheumatology. 7th ed. Philadelphia: Elsevier; 1306–1315, 2019.
  2. Ohashi K, Sequist LV, Arcila ME, et al. Characteristics of lung cancers harboring NRAS mutations. Clin Cancer Res. 2013 May 1;19(9):2584–2591.
  3. Olivier M, Hollstein M, Hainaut P. TP53 mutations in human cancers: Origins, consequences, and clinical use. Cold Spring Harb Perspect Biol. 2010 Jan;2(1):a001008.
  4. Orrell RW, Johnston HM, Gibson C, et al. Spontaneous abdominal hematoma in dermatomyositis. Muscle Nerve. 1998 Dec;21(12):1800–1803.
  5. Langguth DM, Wong RC, Archibald C, Hogan PG. Haemorrhagic myositis associated with prophylactic heparin use in dermatomyositis. Ann Rheum Dis. 2004;63(4):464–465.
  6. Higashi Y, Mera K, Kanzaki T, Kanekura T. Fatal muscle haemorrhage attributable to heparin administration in a patient with dermatomyositis. Clin Exp Dermatol. 2009 Apr;34(3):448–449.
  7. Yamagishi M, Tajima S, Suetake A, et al. Dermatomyositis with hemorrhagic myositis. Rheumatol Int. 2009 Sep;29(11):1363–1366.
  8. Miwa Y, Muramatsu M, Takahashi R, et al. Dermatomyositis complicated with hemorrhagic shock of the iliopsoas muscle on both sides and the thigh muscle. Mod Rheumatol. 2010 Aug;20(4):420–422.
  9. Hanawa F, Inozume T, Harada K, et al. A case of dermatomyositis accompanied by spontaneous intramuscular hemorrhage despite normal coagulability. Rheumatol Int. 2013;33(11):2949–2950.
  10. Patel D, Kamangar N. Hemorrhagic shock from spontaneous retroperitoneal bleed in a patient with dermatomyositis [meeting abstract]. Chest. 2013 Oct;144(4):330A.
  11. Aylanç N, Reşorlu M, Adam G, et al. Dermatomyositis complicated case with muscular hematoma. Int J Clin Res. 2014;2(4):180–182.
  12. Van Gelder H, Wu KM, Gharibian N, et al. Acute hemorrhagic myositis in inflammatory myopathy and review of the literature. Case Rep Rheumatol. 2014;2014:639756.
  13. Chen YH, Wu PC, Ko PY, Lin YN. Retroperitoneal hematoma mimicking exacerbation of dermatomyositis. Intern Med. 2015;54(8):995–996.
  14. Adachi R, Muro Y, Kono M, Akiyama M. Intramuscular haemorrhage in a patient with dermatomyositis and anti-TIF1γ antibodies. Eur J Dermatol. 2018 Feb 1;28(1):116–118.
  15.  Lee JY, Kim J. Significant muscle hemorrhage associated with low-molecular-weight heparin use in dermatomyositis: A case report. J Med Cases. 2019 Sep;10(9):280–283.
  16. Chandler JM, Kim YJ, Bauer JL, Wapnir IL. Dilemma in management of hemorrhagic myositis in dermatomyositis. Rheumatol Int. 2020 Feb;40(2):331–336.
  17. Acharya N, Dhooria A, Jha S, Sharma A. Hemorrhagic myositis: Fatal presentation of a common muscle disease. J Clin Rheumatol. 2020 Aug;26(5):e112.
  18. Li Fraine S, Coman D, Guignard VV, Costa J-P. Spontaneous retroperitoneal hemorrhage in dermatomyositis. Am J Med. 2021 Feb;134 (2):e137-e138.

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Filed under:ConditionsMyositis Tagged with:case reportdermatomyositis (DM)hemorrhagic dermatomyositis

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