Case report:: successful treatment of alveolar hypoventilation due to dermatomyositis with anti-tumour necrosis factor-alpha
Case report:: successful treatment of alveolar hypoventilation due to dermatomyositis with anti-tumour necrosis factor-alpha
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DOI：
10.1093/rheumatology/keh226
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发表时间：
2004-07-01
期刊：
影响因子：
5.5
通讯作者：
Büyükkidan, B
中科院分区：
文献类型：
--
作者：
Korkmaz, C;Temiz, G;Büyükkidan, B
SIR，皮肌炎（DM）病程中可见呼吸系统并发症，但呼吸肌无力导致肺泡通气不足的报道并不常见[1, 2]。肺泡通气不足可能对常规药物产生耐药性，这可能导致死亡或依赖家庭机械通气 [2, 3]。我们介绍了一名患有肺泡通气不足的 DM 患者，该患者对联合免疫抑制治疗没有反应。开始抗肿瘤坏死因子-α（抗TNF-a）治疗后，她的通气功能不全得到了改善。一名19岁女孩因除了发声困难外还有吞咽困难1个月的病史入院。体检发现天芥菜皮疹和甲周红斑。她的近端肌肉力量为 2/5。她的红细胞沉降率（ESR）为28毫米/小时。血清肌酶水平升高：肌酐激酶（CK）3050 U/l（正常16-190）、乳酸脱氢酶（LDH）1257U/l（正常240-480）、天冬氨酸转氨酶（AST）284U/l（正常0-40）、丙氨酸
SIR, Respiratory complications can be seen in the course of dermatomyositis (DM), but alveolar hypoventilation due to respiratory muscle weakness has only been infrequently reported [1, 2]. Alveolar hypoventilation can be resistant to conventional agents, which may result in either death or dependence on home mechanical ventilation [2, 3].We present a patient with DM with alveolar hypoventilation who failed to respond to a combined immunosuppressive treatment. The initiation of anti-tumour necrosis factor-alpha (anti-TNF-a) resulted in improvement in her ventilatory insufficiency. A 19-yr-old girl was admitted to hospital with a 1-month history of having difficulty in swallowing apart from dysphonia. Physical examination disclosed heliotrope rashes and periungual erythema. Her proximal muscle power was 2/5. Her erythrocyte sedimentation rate (ESR) was 28mm/h. Serum levels of muscle enzymes were increased: creatinine kinase (CK) 3050 U/l (normal 16–190), lactate dehydrogenase (LDH) 1257U/l (normal 240–480), aspartate aminotransferase (AST) 284U/l (normal 0–40), alanine