Dermatomyositis masquerading musculoskeletal tuberculosis

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Abstract

Dermatomyositis is a rare rheumatic disease which predominantly affects the muscles and skin requiring a protracted course of immunosuppressants which may predispose the patients to opportunistic infections. A 49-year-old lady was diagnosed to have dermatomyositis in August 2010 based on history, significantly raised creatine kinase level and muscle biopsy findings. She had recurrent admissions due to fever, myalgia and muscle weakness. She had spiking temperature despite high dose steroids, broad-spectrum antibiotics and antifungal agents. This prompted extensive investigation which leads us to the additional diagnosis of disseminated tuberculosis involving the lungs, muscles and bones. This case demonstrates the challenge in controlling the disease activity of dermatomyositis with immunosuppressants in the setting of disseminated tuberculosis.

Original languageEnglish
JournalBMJ Case Reports
DOIs
Publication statusPublished - 2011

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Dermatomyositis
Tuberculosis
Immunosuppressive Agents
MM Form Creatine Kinase
Muscles
Antifungal Agents
Myalgia
Opportunistic Infections
Muscle Weakness
Rare Diseases
Rheumatic Diseases
Fever
History
Steroids
Anti-Bacterial Agents
Biopsy
Bone and Bones
Lung
Skin
Temperature

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Dermatomyositis masquerading musculoskeletal tuberculosis",
abstract = "Dermatomyositis is a rare rheumatic disease which predominantly affects the muscles and skin requiring a protracted course of immunosuppressants which may predispose the patients to opportunistic infections. A 49-year-old lady was diagnosed to have dermatomyositis in August 2010 based on history, significantly raised creatine kinase level and muscle biopsy findings. She had recurrent admissions due to fever, myalgia and muscle weakness. She had spiking temperature despite high dose steroids, broad-spectrum antibiotics and antifungal agents. This prompted extensive investigation which leads us to the additional diagnosis of disseminated tuberculosis involving the lungs, muscles and bones. This case demonstrates the challenge in controlling the disease activity of dermatomyositis with immunosuppressants in the setting of disseminated tuberculosis.",
author = "Sakthiswary Rajalingham and {Mohamed Said}, {Mohd Shahrir} and Shaharir, {Syahrul Sazliyana} and Aini AbAziz and {K Periyasamy}, {Petrick @ Ramesh} and Anshar, {Fauzi Md}",
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AU - Mohamed Said, Mohd Shahrir

AU - Shaharir, Syahrul Sazliyana

AU - AbAziz, Aini

AU - K Periyasamy, Petrick @ Ramesh

AU - Anshar, Fauzi Md

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