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Article in Japanese
A case of myocarditis associated with polymyositis preceded by interstitial pneumonia
Minako Hamada1)2) Yoshifusa Koreeda1) Jiro Nakashioya1) Toshifumi Kawabata1) Yumiko Tomiyama1) Masaharu Kawabata1) Hisamichi Aizawa2)
1)Department of Respiratory Medicine, Minami Kyushu National Hospital 2)Department of Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University
A 33-year old man was admitted to our hospital because of an abnormal shadow on the chest radiograph, dry cough, and exertional dyspnea. Chest radiograph and high-resolution computed tomography (HRCT) on admission showed ground-glass opacities and bronchiectasis with volume loss in the bilateral dorsal areas. Thoracoscopic lung biopsy specimens showed mainly a pattern of NSIP (nonspecific interstitial pneumonia). We considered this case as hypersensitivity pneumonia or interstitial pneumonia (IP) associated with collagen disease. Oral prednisolone (PSL) was initiated at 55 mg/day (1 mg/kg). However he complained of proximal muscle weakness and pain and difficulty of breathing. He had heart failure due to the myocarditis. We established a diagnosis of IP associated with polymyositis and it was confirmed by his symptoms, muscle biopsy findings and elevation of serum CPK. We considered this case as the myocarditis due to polymyositis.
Interstitial pneumonia Polymyositis/Dermatomyositis Myocarditis
Received 平成23年1月28日
JJRS, 49(9): 674-680, 2011