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Rheumatology International

, Volume 40, Issue 2, pp 331–336 | Cite as

Dilemma in management of hemorrhagic myositis in dermatomyositis

  • Julia M. ChandlerEmail author
  • Yoo Jung Kim
  • Justin L. Bauer
  • Irene L. Wapnir
Case Based Review

Abstract

Dermatomyositis (DM) is a rare inflammatory disorder affecting the muscle and skin. DM patients can present with spontaneous muscle hemorrhage, a potentially fatal complication. The best practice for management of hemorrhagic myositis in these patients remains unclear. Here we discuss the case of a patient who presented with progressive muscle weakness and intermittent rash that was diagnosed with dermatomyositis. During admission, she developed spontaneous hemorrhagic myositis of the right pectoralis major treated with surgical evacuation. She also developed a spontaneous left anterior thigh hematoma which was treated conservatively. She recovered and showed no evidence of recurrent bleeding at either location. We performed a literature review and identified ten cases of spontaneous hemorrhage in DM patients, with a 60% mortality rate among reported cases. Given the high mortality rate associated with spontaneous hemorrhage in DM patients, it is important for physicians to be aware of the diagnosis, workup, and management strategies.

Keywords

Dermatomyositis complications Myositis Hemorrhage Hematoma 

Notes

Acknowledgements

The authors would like to thank Dr. Matthew Lewis for his review of the manuscript.

Author contributions

JC conceived the study and drafted and critically revised the manuscript. YK performed the literature search and drafted and critically revised the manuscript. JB critically revised the manuscript and provided guidance on radiologic findings. IW critically revised the manuscript and provided overall guidance for the project. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.

Funding

There was no funding provided for this report.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Informed consent

Informed consent was obtained from the patient described in the study, including permission for release of photographs.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryStanford University School of MedicineStanfordUSA
  2. 2.Stanford University School of MedicineStanfordUSA
  3. 3.Department of RadiologyStanford University School of MedicineStanfordUSA

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