Drop Head Syndrome as a Rare Complication in Mixed Connective Tissue Disease

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  • Akagi Midori
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Umeda Masataka
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan Medical Education Development Center, Nagasaki University Hospital, Japan
  • Hashisako Mikiko
    Department of Anatomic Pathology, Graduate School of Medicine Sciences, Kyushu University, Japan
  • Hara Kazusato
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Tsuji Sousuke
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Endo Yushiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Takatani Ayuko
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Shimizu Toshimasa
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Fukui Shoichi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Koga Tomohiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kawashiri Shin-ya
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Iwamoto Naoki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Igawa Takashi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Ichinose Kunihiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Tamai Mami
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Nakamura Hideki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Origuchi Tomoki
    Department of Physical Therapy Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
  • Niino Daisuke
    Nagasaki Educational and Diagnostic Center of Pathology, Nagasaki University Hospital, Japan
  • Kawakami Atsushi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan

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Abstract

<p>A 54-year-old woman developed drop head syndrome (DHS), Raynaud's phenomenon and creatine kinase (CK) elevation. She did not meet the international classification criteria of dermatomyositis/polymyositis, as we observed no muscle weakness, grasping pain or electromyography abnormality in her limbs, and anti-aminoacyl tRNA synthetase (ARS) antibody was negative. Cervical magnetic resonance imaging and a muscle biopsy of the trapezius muscle revealed myositis findings as the only clinical observations in muscle. These findings, along with her anti-U1-ribonucleoprotein (RNP) antibody positivity and leukopenia, resulted in a diagnosis of mixed connective tissue disease (MCTD). Prednisolone treatment significantly improved her myositis. To our knowledge, this is the first report of DHS as the only muscle complication of MCTD. </p>

Journal

  • Internal Medicine

    Internal Medicine 59 (5), 729-732, 2020-03-01

    The Japanese Society of Internal Medicine

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