皮膚筋炎の精査中にサルコイドーシスの合併が判明した1例  [in Japanese] Dermatomyositis Complicated by Sarcoidosis  [in Japanese]

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Abstract

我々は皮膚筋炎の精査中にサルコイドーシスの合併が判明した1例を経験した. 症例は57歳, 女性で, 発熱・乾性咳嗽・筋痛を主訴に当院を受診した. 皮膚筋炎に特徴的な皮疹と筋炎及び胸部X線上の間質性陰影から臨床的には皮膚筋炎とそれに伴う間質性肺炎が疑われた. しかし, <sup>67</sup>Gaシンチグラフィーにて取込みのあった唾液腺と肺・筋肉から生検を行ったところ, 非乾酪性肉芽腫が証明された. また, 眼科的にはぶどう膜炎が認められ, サルコイドーシスが存在すると考えられた. 肺の組織は非乾酪性肉芽腫以外に, 膠原病に認められる間質性肺炎の像を呈していた. 特徴的な皮疹と肺の病理所見はサルコイドーシスでは説明できず, 稀な病態であるが, 本症例は皮膚筋炎とサルコイドーシスの合併と考えられた. サルコイドーシスは病理学的検査を施行しなければ判明しておらず, 病理学的検査の重要性が再認識された.

We encountered a patient with dermatomyositis complicated by sarcoidosis. A 57-year-old woman was admitted to our hospital because of fever, dry cough, and myalgias. There were reticular shadows on her chest X-ray film. Although the typical skin rash and myostitis suggested the diagnosis of dermatomyositis, biopsy specimens from a salivary gland, muscle, and lung revealed noncaseating granulomas as well. Uveitis was also noted. These findings suggested the coexistence of sarcoidosis with dermatomyositis. Examination of the lung-biopsy specimens showed interstitial pneumonia compatible with dermatomyositis, except for the granuloma. The typical rash of dermatomyositis and pathological findings of the lung specimen were inconsistent with sarcoidosis. Therefore we concluded that this patient had both dermatomyositis and sarcoidosis. This case sheds new light on the importance of pathological examinations.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 34(11), 1255-1259, 1996-11-25

    The Japanese Respiratory Society

References:  11

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008111605
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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