Dermatomyositis: analysis of 109 patients surveyed at the CHSPU / Dermatomiosite: estudo de 109 pacientes avaliados no HCFMUSP

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Dermatomyositis is a chronic idiopathic inflammatory disorder which affects the striated skeletal muscles, the skin, and other organs. This present study aims at characterizing the patients who have been affected by this disease and were under treatment at HCFMUSP from January, 1992 to December, 2002 Its classification, the cutaneous and systemical manifestations, as well as laboratorial, therapeutical and evolutive findings were checked out in accordance with the literature. The base for this study was the data obtained from the analysis of 109 patients´records who met not only Bohans and Peters criteria for dermatomyositis diagnosis but also the ones modified by Drake. The patients were divided into five groups: 23 juvenile dermatomyositis, 59 idiopatic primary dermatomyositis, 6 amyopatic dermatomyositis, 7 dermatomyositis associated to malignancy and 14 dermatomyositis associated to connective tissue disorder Sixty of these patients were classified as definite diagnostic, 33 as possible, 4 as probable and 12 as amyopathic. Most patients were female (85/109) and the average age for the diagnosis of the illness was 36. Skin manifestations were observed in all patients, while regarding the systemical alterations, the most frequent was the loss of proximal strength (88%). As the lung manifestation, the most common was an interstitial pneumopathy (16,5%) and as the digestive manifestation, the one which was more commonly observed was gastritis (20,2%). Neoplasies were documented after the following up of the disease in 6,42% of the cases, which was more frequent in patients over 60 years of age (71,4%). The muscle enzyme modified in the majority of the cases was the lactic dehydrogenize (78,6%). Skin biopsy procedure was carried out in 68 patients who showed compatible changes to anatomo-pathological exam in 78% of the cases; 53 patients went under muscular biopsy and 96 % of them proved to have myositis after anatomo-pathological exams. From the fifty-eight electroneuromiographies that were carried out, 81% of the cases showed to have compatible myopathic patterns. Steroidal drugs were the most common therapy used. The mortality rate was 14,7% and the most usual causes of death were malignant neoplasm, sepsis and pulmonary infection.

ASSUNTO(S)

dermatomiosite/classificação dermatomyositis/classification connective tissue/pathology dermatomiosite/complicações biópsia dermatomyositis/complications biopsy tecido conectivo/patologia electromyography eletromiografia

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