A Case of Fulminant Type of Dermatomyositis, Associated With Achute Renal Failure

Izumi, Namiki; Miyakawa, Happei; Nakayama, Isao; Sakamoto, Shigemi; Kijima, Yoshimaro; Shoji, Takao; Sasaoka, Taro; Kanayama, Masaaki; Tomura, Shigeo; Takeuchi, Jugoro

doi:10.2169/naika.69.1312

Cited by 4 publications

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“…Dermatomyositis and polymyositis have been known to be associated with an increased frequency of internal malignancies [6,7], Dermatomyositis is associated with malignancy more frequently than is polymyositis [8]. In fact, suggested classifications include a category o f 'der matomyositis and polymyositis with neoplasia' [5], But a carefully controlled and prospective study is needed to support this notion unequivocally [9,10], Although myoglobulinuria and myoglobulinemia are not uncommon in patients with dermatomyositis [11], acute renal failure in association with dermatomyositis has been reported only in a few patients [1][2][3][4]. The infre quent occurrence of renal failure may be related to a less severe degree of myoglobulinuria in these patients [11] or to lack of other known predisposing factors in the pres ence of which myoglobulinuric renal failure commonly gets precipitated [12], The factors predictive of renal fail ure in this setting include the degree of serum creatine kinase, serum potassium, and the serum phosphorus level elevation; the degree of depression of serum albu min level; and the presence of dehydration or sepsis as the underlying cause [13].…”

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confidence: 99%

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Acute Renal Failure Associated with Dermatomyositis and Colon Cancer

Park

Cho

Kang

1990

Nephron

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confidence: 99%

“…The kidneys are generally spared in dermatomyositis. A few cases of acute renal failure in dermatomyositis have been reported [1][2][3][4]. This report describes a case of acute renal failure associated with dermatomyositis and colon cancer in which the renal necropsy showed a typical acute tubular necrosis associated with nontraumatic rhabdomyolysis.…”

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confidence: 98%

Acute Renal Failure Associated with Dermatomyositis and Colon Cancer

Park

Cho

Kang

1990

Nephron

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Unusual renal involvement of polymyositis complicated with malignant hypertension

Watanabe

Takahashi

Sawai

1999

Japanese Journal of Rheumatology

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We report an autopsy case of polymyositis (PM) with unusual renal involvement representing malignant hypertension. The histopathological findings of the kidneys revealed marked onion-peel-like duplication of internal lamina and fibrous thickening of intima in the arteries. Arterioles showed hyalinous thickening of intima with marked luminal narrowing. In some glomeruli, fibrinoid necrosis of the capillary tuft were observed, and in these portions, afferent and efferent arterioles were also affected by the same changes. Immunohistochemical findings were the deposition of immunoglobulin M and complement Clq in the wall of vessels and the capillary tuft of glomeruli. Renin-secreting cells in the juxtaglomerular apparatus showed hyperplasia, corresponding with elevated serum renin and aldosterone activity. These histological and clinical findings were similar to those of scleroderma renal crisis. It is suggested that the immunological mechanism, mediated by immune complex and complement deposition, was responsible for the pathogenesis of this renal lesion.

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Disseminated Intravascular Coagulation Induced by Generalized Cytomegalic Inclusion Disease During Steroid Therapy for Polymyositis

Shimizu

Kishikawa

Sekine

et al. 1985

Acta Pathologica Japonica

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A 56‐year‐old woman came to the hospital with fever and skin eruptions. A rise in myogenic enzyme and the presence of antileucocyte antibody were noticed, along with the gradual appearance of myalgia in both lower extremities, and muscle weakness. Steroid therapy was started under the diagnosis of polymyositis. The steroid was reduced because of mental disturbance but immediately the patient developed high fever. Various forms of treatment were carried out but there was no improvement, and the patient died. At autopsy there were scattered purpura on the skin, and the muscles were atrophic and yellowish‐grey in color. Histopathologically, there was inflammatory cell infiltration and muscle fiber degeneration visible in many of the muscles, and the findings showed evidence of polymyositis. There were intranuclear inclusions in the lungs, ovaries, and adrenal glands, and this was diagnosed as generalized cytomegalic inclusion disease. Fibrin thrombi were found in the kidneys, lungs, and adrenal glands and this was pathologically diagnosed as disseminated intravascular coagulation. Endothelial cell damage caused by cytomegalovirus was assumed to be involved to a large extent in triggering the disseminated intravascular coagulation. ACTA PATHOL. JPN. 35: 723–730, 1985.

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A Case of Fulminant Type of Dermatomyositis, Associated With Achute Renal Failure

Cited by 4 publications

References 0 publications

Acute Renal Failure Associated with Dermatomyositis and Colon Cancer

Acute Renal Failure Associated with Dermatomyositis and Colon Cancer

Unusual renal involvement of polymyositis complicated with malignant hypertension

Disseminated Intravascular Coagulation Induced by Generalized Cytomegalic Inclusion Disease During Steroid Therapy for Polymyositis

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