Female patient, 30 years old with no relevant personal history.
The patient was admitted to the Medical Clinic due to asthenia, weakness and proximal myalgia of 1 and a half month of evolution.
She also reported polyarthralgia and swallowing disorders.
The initial physical examination revealed edema and pigmentation of the eyelids and alopecia plaques in the scalp, with no other skin lesions.
After 15 days, painful, warm erythematous plaques and nodules appeared in the proximal region of the upper and lower limbs.
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Biopsy of them (Protocol No 213124) reports: panlobular with mucin deposits linked to collagenopathy.
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The following studies were conducted:
Laboratory data (Summary data)
Electromyogram showed no neurogenic involvement.
Some mild proximal myogenic signs.
Biopsy of the deltoid muscle (Protocol No 212999): Multifocal perimysial and perivascular lymphoplasmacytic inflammatory infiltrate.
Necrosis isolated from myofibers.
Two-dimensional echocardiography, abdominal ultrasound, high resolution chest CT and brain: s/p
Spirometry: mild restrictive ventilatory defect
Gynecologic evaluation: no particularities
Evaluation by otorhinolaryngology: videofluoroendopharyngeal manifestation of dysphagia mild degree with lack of intraoral pressure.
Diagnosis: Pancreatitis
Treatment with meprednisone 60 mg/day was initiated with good clinical response: resolution of the lesions of pancream, improvement of the muscular and laboratory symptoms a week after starting the steroid treatment.
