Clinical Analysis of 5 Patients with Amyopathic Dermatomyositis_West China Medical Journal

Authors：

LUO Rui , LIU Gang.

Department of Rheumatology，West China Hospital，Sichuan University,Chengdu 610041，China;

Corresponding author：

Keywords：

皮肌炎; 无肌病性

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目的：探讨无肌病性皮肌炎的临床特点。方法：回顾性分析符合Euwer提出的ADM诊断标准的5例患者的临床资料，包括临床症状体征、肌酶谱、肌电图、肌肉病理检查、胸部影像学检查、治疗方案。结果：所有患者均先后出现皮肌炎典型皮损，无肌痛或肌无力等主诉，肌酶谱、肌电图均正常。2例抗核抗体阳性，3例有肌活检非特异性改变，1例合并间质性肺炎，无患者合并恶性肿瘤。结论：皮肌炎是一种复杂的综合征，需要行全身系统检查，结合肌电图和肌肉病理检查进行综合诊断。

Citation： LUO Rui,LIU Gang.. Clinical Analysis of 5 Patients with Amyopathic Dermatomyositis. West China Medical Journal, 2009, 24(2): 358-361. doi: Copy

1.	Jorizzo J.L.Dermatomyositis：practical aspects[J].Arch Dermatol，2002，138(1)：114-6..
2.	Euwer RL Sontheimer RD.Amyopathic dermatomyositis：a review[J].J Invest Dermatol，1993，100(1)：124S-127S..
3.	Euwer，R.L.and R.D.Sontheimer，Amyopathic dermatomyositis(dermatomyositis sine myositis).Presentation of six new cases and review of the literature[J].J Am Acad Dermatol，1991，24(6 Pt 1)：959-966..
4.	Gerami P，et al.A systematic review of adultonset clinically amyopathic dermatomyositis(dermatomyositis sine myositis)：a missing link within the spectrum of the idiopathic inflammatory myopathies[J].J Am Acad Dermatol，2006，54(4)：597-613..
5.	Sato S.et al.Autoantibodies to a 140kd polypeptide，CADM140，in Japanese patients with clinically amyopathic dermatomyositis[J].Arthritis Rheum，2005，52(5)：1571-1576..
6.	Sato S.Autoantibodies specifically detected in patients with polymyositis/dermatomyositis[J].Nihon Rinsho Meneki Gakkai Kaishi，2006，29(2)：85-93..
7.	Yamasaki Y.et al.Unusually high frequency of autoantibodies to PL7 associated with milder muscle disease in Japanese patients with polymyositis/dermatomyositis[J].Arthritis Rheum，2006，54(6)：2004-2009..
8.	Cottin V，et al.Interstitial lung disease in amyopathic dermatomyositis，dermatomyositis and polymyositis[J].Eur Respir J，2003，22(2)：245-250..
9.	Kang EH,et al.Interstitial lung disease in patients with polymyositis，dermatomyositis and amyopathic dermatomyositis[J].Rheumatology(Oxford)，2005，44(10)：1282-1286..
10.	Shimamoto，K.et al.Three cases of polymyositis/dermatomyositis complicated by pneumomediastinum[J].Nihon Rinsho Meneki Gakkai Kaishi，2008，31(1)：56-61..
11.	Tsuda，T.et al.A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multiimmunosuppressive therapy[J].Am J Med Sci，2007，333(3)：185-190..
12.	Ideura G,et al.Interstitial lung disease associated with amyopathic dermatomyositis：review of 18 cases[J].Respir Med，2007，101(7)：1406-1411..
13.	Yokoyama T,et al.Fatal rapidly progressive interstitial pneumonitis associated with amyopathic dermatomyositis and CD8 T lymphocytes[J].J Intensive Care Med，2005，20(3)：160-163..
14.	Kaji K,et al.A case of amyopathic dermatomyositis with acute interstitial pneumonia(DAD pattern)[J].Nihon Rinsho Meneki Gakkai Kaishi，2004，27(2)：103-107..
15.	Kameda H,Takeuchi T Recent advances in the treatment of interstitial lung disease in patients with polymyositis/dermatomyositis[J].Endocr Metab Immune Disord Drug Targets，2006，6(4)：409415..
16.	Miyazaki E,et al.Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(3)：436-439..
17.	Nanke，Y.et al.A case of amyopathic dermatomyositis with rapidly progressive interstitial pneumonia[J].Ryumachi，2000，40(4)：705-710..
18.	Callen，J.P.and R.L.Wortmann，Dermatomyositis[J].Clin Dermatol，2006，24(5)：363-73..
19.	Suber，T.L.L.CasciolaRosen，and A.Rosen，Mechanisms of disease：autoantigens as clues to the pathogenesis of myositis[J].Nat Clin Pract Rheumatol，2008，4(4)：201-9..
20.	elAzhary，R.A.and S.Y.Pakzad，Amyopathic dermatomyositis：retrospective review of 37 cases[J].J Am Acad Dermatol，2002，46(4)：560-5..
21.	Lam WW，et al.MR imaging in amyopathic dermatomyositis[J].Acta Radiol，1999，40(1)：69-72..
22.	Sugisaki，K.et al.Prevention of progression of interstitial lung lesions by early combination therapy with corticosteroids and cyclosporine/cyclophosphamide in two patients with amyopathic dermatomyositis[J].Fukushima J Med Sci，2002，48(2)：103-10..
23.	Kuroda，T.et al.A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A[J].Clin Rheumatol，2003，22(1)：45-8..
24.	Ohmichi，M.et al.A case of nonspecific interstitial pneumonia associated with amyopathic dermatomyositis efficiently treated with a combination of cyclosporin A and prednisolone[J].Nihon Kokyuki Gakkai Zasshi，2002，40(6)：478-83..
25.	Aslanidis，S.et al.Successful treatment of refractory rash in paraneoplastic amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(7)：1198-200..
26.	Iorizzo，L.J.and J.L.Jorizzo，The treatment and prognosis of dermatomyositis：an updated review[J].J Am Acad Dermatol，2008，59(1)：99-112.

1. Jorizzo J.L.Dermatomyositis：practical aspects[J].Arch Dermatol，2002，138(1)：114-6..
2. Euwer RL Sontheimer RD.Amyopathic dermatomyositis：a review[J].J Invest Dermatol，1993，100(1)：124S-127S..
3. Euwer，R.L.and R.D.Sontheimer，Amyopathic dermatomyositis(dermatomyositis sine myositis).Presentation of six new cases and review of the literature[J].J Am Acad Dermatol，1991，24(6 Pt 1)：959-966..
4. Gerami P，et al.A systematic review of adultonset clinically amyopathic dermatomyositis(dermatomyositis sine myositis)：a missing link within the spectrum of the idiopathic inflammatory myopathies[J].J Am Acad Dermatol，2006，54(4)：597-613..
5. Sato S.et al.Autoantibodies to a 140kd polypeptide，CADM140，in Japanese patients with clinically amyopathic dermatomyositis[J].Arthritis Rheum，2005，52(5)：1571-1576..
6. Sato S.Autoantibodies specifically detected in patients with polymyositis/dermatomyositis[J].Nihon Rinsho Meneki Gakkai Kaishi，2006，29(2)：85-93..
7. Yamasaki Y.et al.Unusually high frequency of autoantibodies to PL7 associated with milder muscle disease in Japanese patients with polymyositis/dermatomyositis[J].Arthritis Rheum，2006，54(6)：2004-2009..
8. Cottin V，et al.Interstitial lung disease in amyopathic dermatomyositis，dermatomyositis and polymyositis[J].Eur Respir J，2003，22(2)：245-250..
9. Kang EH,et al.Interstitial lung disease in patients with polymyositis，dermatomyositis and amyopathic dermatomyositis[J].Rheumatology(Oxford)，2005，44(10)：1282-1286..
10. Shimamoto，K.et al.Three cases of polymyositis/dermatomyositis complicated by pneumomediastinum[J].Nihon Rinsho Meneki Gakkai Kaishi，2008，31(1)：56-61..
11. Tsuda，T.et al.A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multiimmunosuppressive therapy[J].Am J Med Sci，2007，333(3)：185-190..
12. Ideura G,et al.Interstitial lung disease associated with amyopathic dermatomyositis：review of 18 cases[J].Respir Med，2007，101(7)：1406-1411..
13. Yokoyama T,et al.Fatal rapidly progressive interstitial pneumonitis associated with amyopathic dermatomyositis and CD8 T lymphocytes[J].J Intensive Care Med，2005，20(3)：160-163..
14. Kaji K,et al.A case of amyopathic dermatomyositis with acute interstitial pneumonia(DAD pattern)[J].Nihon Rinsho Meneki Gakkai Kaishi，2004，27(2)：103-107..
15. Kameda H,Takeuchi T Recent advances in the treatment of interstitial lung disease in patients with polymyositis/dermatomyositis[J].Endocr Metab Immune Disord Drug Targets，2006，6(4)：409415..
16. Miyazaki E,et al.Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(3)：436-439..
17. Nanke，Y.et al.A case of amyopathic dermatomyositis with rapidly progressive interstitial pneumonia[J].Ryumachi，2000，40(4)：705-710..
18. Callen，J.P.and R.L.Wortmann，Dermatomyositis[J].Clin Dermatol，2006，24(5)：363-73..
19. Suber，T.L.L.CasciolaRosen，and A.Rosen，Mechanisms of disease：autoantigens as clues to the pathogenesis of myositis[J].Nat Clin Pract Rheumatol，2008，4(4)：201-9..
20. elAzhary，R.A.and S.Y.Pakzad，Amyopathic dermatomyositis：retrospective review of 37 cases[J].J Am Acad Dermatol，2002，46(4)：560-5..
21. Lam WW，et al.MR imaging in amyopathic dermatomyositis[J].Acta Radiol，1999，40(1)：69-72..
22. Sugisaki，K.et al.Prevention of progression of interstitial lung lesions by early combination therapy with corticosteroids and cyclosporine/cyclophosphamide in two patients with amyopathic dermatomyositis[J].Fukushima J Med Sci，2002，48(2)：103-10..
23. Kuroda，T.et al.A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A[J].Clin Rheumatol，2003，22(1)：45-8..
24. Ohmichi，M.et al.A case of nonspecific interstitial pneumonia associated with amyopathic dermatomyositis efficiently treated with a combination of cyclosporin A and prednisolone[J].Nihon Kokyuki Gakkai Zasshi，2002，40(6)：478-83..
25. Aslanidis，S.et al.Successful treatment of refractory rash in paraneoplastic amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(7)：1198-200..
26. Iorizzo，L.J.and J.L.Jorizzo，The treatment and prognosis of dermatomyositis：an updated review[J].J Am Acad Dermatol，2008，59(1)：99-112.

West China Medical Journal

Clinical Analysis of 5 Patients with Amyopathic Dermatomyositis

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