부산대학교 도서관

Introduction: Polymyositis is an inflammatory muscle disease, with autoimmune character. Aim: To present the case of a 15 years adolescent with myopathy. Case report: A 15 years old male patient was admitted to the hospital complaining of severe muscle pain in the arms and legs. Clinical exam revealed: warm teguments, muscular hypertonia, limited flexion of the legs on the thighs, limited extension of the arms and rising of the arms over the head. Laboratory findings: CK = 603 U/L, LDH = 999 U/L, ESR = 30 mm/h; CRP = 46.2 mg%. The neurological exam found: secondary inflammatory myopathy. EMG: hyper-voltage potentials with short duration, increased pattern of recruitment, suggestive for a myopathy. Muscle biopsy revealed: local atrophy of muscle fibers, endomysium inflammatory lymphocytic infiltrate and perivascular infiltration. Myositis-specific antibodies (Anti-Mi-2, Anti Jo-1, Anti SRP, Anti Pl-7, Anti Pl-12, Anti EJ, Anti OJ) and myositis-associated antibodies (Anti Ku, Anti Pm-Scl 100, Anti Pm-Scl 75, Anti Ro-52) were all negative. The results of the investigations correlated with the clinical context leaded to the diagnostic of Primary idiopathic polymyositis. Pulse corticosteroid therapy with intravenous Methylprednisolone was initiated (1 g per day for 3 days), and then orally corticosteroid therapy with Prednisone (80 mg per day, with progressive decrease of the dose). The symptoms remitted after therapy, the muscular enzymes normalised but the inflammatory syndrome persists and so does the EMG myogenic route. Particularity of the case: male patient with negative specific antibodies and arthropathic onset. [ABSTRACT FROM AUTHOR]