Vol.20 No.4

Case Report

Dermatomyositis complicated with hemorrhagic shock of the iliopsoas muscle on both sides and the thigh muscle

Authors

Yusuke Miwa1 , Mizuho Muramatsu1 , Ryo Takahashi1 , Kuninobu Wakabayashi1 , Tsuyoshi Odai1 , Takeo Isozaki1 , Nobuyuki Yajima1 , Tsuyoshi Kasama1

  • Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
Received:

16 November 2009

Accepted:

8 March 2010

Published online:

8 April 2010

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Abstract

A 65-year-old Japanese woman, diagnosed with dermatomyositis with myopathy and characteristic skin lesion, was intravenously administered methylprednisolone 500 mg per day for 3 days, followed by prednisolone 60 mg po per day. Four days later, she went into shock. Computed tomography of the abdomen showed hematoma in the iliopsoas muscle on both sides and a thigh muscle. Intravenously administered heparin was stopped, and 4 U of packed cells and 4 U of fresh frozen plasma were transfused. The patient subsequently developed pulmonary edema requiring assisted ventilation, and made a successful recovery, returning home after a short period of intensive rehabilitation.

Key words

Dermatomyositis - Iliopsoas muscle - Thigh muscle - Shock - Hemorrhage