Gastrointestinal Involvement in Dermatomyositis
Matas-Garcia, Ana (Hospital Clínic i Provincial de Barcelona)
Milisenda, José César (Hospital Clínic i Provincial de Barcelona)
Espinosa, Gerard (Hospital Clínic i Provincial de Barcelona)
Cuatrecasas, Miriam (Hospital Clínic i Provincial de Barcelona)
Selva O'Callaghan, Albert (Hospital Universitari Vall d'Hebron)
Grau, Josep María (Hospital Clínic i Provincial de Barcelona)
Prieto-González, Sergio (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Dermatomyositis is a systemic vasculopathy mainly affecting skin, muscle and lung, but may affect the gastrointestinal tract. We aim to describe clinical characteristics of patients with severe gastrointestinal involvement related to dermatomyositis in our center and medical literature. We retrospectively analysed these patients in our center, including cases of erosions/ulcers, perforation or digestive bleeding. Reported cases from April 1990 to April 2021 were reviewed through PubMed and Cochrane. From our cohort (n = 188), only 3 presented gastrointestinal compromise. All were women (10, 46 and 68 years). The initial symptom was abdominal pain and all had ≥2 episodes of digestive bleeding. All died due to complications of gastrointestinal involvement. Available pathological samples showed vascular ectasia. From the literature review (n = 50), 77% were women with a mean age of 49 years and the main symptom was abdominal pain (65%). All presented active muscular and cutaneous involvement at complication diagnosis. Mortality was 41. 7%. The underlying lesion was perforation or ulcer (n = 22), intestinal wall thickening (n = 2), macroscopic inflammation (n = 2) or intestinal pneumatosis (n = 15). In 13 cases, vasculitis was described. Gastrointestinal involvement in dermatomyositis denotes severity, so an early intensive treatment is recommended. Pathological findings suggest that the underlying pathophysiological mechanism is a vasculopathy and not a true vasculitis.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Dermatomyositis ; Gastrointestinal involvement ; Gastrointestinal perforation ; Gastrointestinal bleeding ; Intestinal pneumatosis
Publicat a:	Diagnostics, Vol. 12 (may 2022) , ISSN 2075-4418

DOI: 10.3390/diagnostics12051200
PMID: 35626355

11 p, 2.5 MB

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