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Rheumatology Advance Access originally published online on February 28, 2003
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Rheumatology 2003; 42: 575-582
© 2003 British Society for Rheumatology

Grand Rounds in Rheumatology

Presentation and management of idiopathic inflammatory muscle disease: four case reports and commentary from a series of 78 patients

P. D. W. Kiely, C. W. Heron1 and F. E. Bruckner

Departments of Rheumatology and
1 Radiology, St George's Healthcare NHS Trust, Blackshaw Road, London SW17 0QT, UK

The first 150 words of the full text of this article appear below.

We present four case histories from a series of 78 patients with idiopathic inflammatory muscle disease at St George's Healthcare NHS Trust. These cases illustrate some of the complexities in the presentation and natural history of inflammatory muscle disease, which may present pitfalls to the unsuspecting clinician. The cases illustrate the benefits of intensive therapy with standard immunosuppression, intravenous immunoglobulins (i.v. Ig) and prolonged airway protection in certain situations. We also describe the role of muscle magnetic resonance imaging (MRI) in the diagnosis and management of inflammatory muscle disease.

Case 1

Diagnosis: Dermatomyositis with dysphagia.

Treatment: Prednisolone, cyclosporin, i.v. Ig, percutaneous endoscopic gastrostomy (PEG) tube.

A 68-yr-old Asian man was admitted with a 3-month history of a rash on the face, ears, neck, arms and legs, with itchy puffy eyes. He had also noticed weakness with difficulty getting out of bed and climbing stairs. In the last month he had . . . [Full Text of this Article]

Comment

Case 2

Comment

Case 3

Comment

Case 4

Comment

Discussion

Intravenous immunoglobulin treatment
Muscle magnetic resonance imaging
Management algorithm

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