A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A

Clin Rheumatol. 2003 Feb;22(1):45-8. doi: 10.1007/s10067-002-0675-0.

Abstract

We describe a rare case of a 46-year-old Japanese man with dermatomyositis (DM) and interstitial lung disease who developed spontaneous pneumomediastinum and subcutaneous emphysema. Relatively mild myositis, mild elevation of CK values and the absence of anti-Jo-1 antibody were observed and the case was similar to amyopathic DM. Treatment of this patient with oral prednisolone and cyclosporin A (CsA) was effective for the myositis and interstitial lung disease. The administration of CsA enabled rapid tapering of the dose of prednisolone without aggravating the disease. Pneumomediastinum and subcutaneous emphysema disappeared 5 months later without recurrence. The serum levels of KL-6 were monitored every 2 weeks to help determine whether this may have contributed to the recurrence of interstitial pneumonitis. This is a rare case of pneumomediastinum in a patient with DM.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Anti-Inflammatory Agents / administration & dosage
  • Antigens / blood
  • Antigens, Neoplasm
  • Cyclosporine / administration & dosage
  • Cyclosporine / therapeutic use*
  • Dermatomyositis / complications*
  • Dermatomyositis / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Glycoproteins / blood
  • Humans
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / etiology
  • Lung Diseases, Interstitial / immunology
  • Male
  • Mediastinal Emphysema / diagnostic imaging
  • Mediastinal Emphysema / etiology*
  • Middle Aged
  • Mucin-1
  • Mucins
  • Prednisolone / administration & dosage
  • Radiography, Thoracic
  • Tomography, X-Ray Computed

Substances

  • Anti-Inflammatory Agents
  • Antigens
  • Antigens, Neoplasm
  • Glycoproteins
  • MUC1 protein, human
  • Mucin-1
  • Mucins
  • Cyclosporine
  • Prednisolone