Kang Jian Yuan Repeated cough and shortness of breath, beware of dermatomyositis

Mondo Health Updated on 2024-02-22

If your relatives and friends are coughing and shortness of breath, your first reaction is to go to the hospital to find a respiratory doctor to check for asthma, pneumonia and other diseasesThere is nothing wrong with this idea, but at the same time, we should not ignore the "autoimmune disease in the guise of respiratory diseases" - dermatomyositis. Dermatomyositis can also cause recurrent coughing and is associated with diseases of all systems throughout the body. Recently, he worked in the movie "Let's Wrestle!".The sudden death of 19-year-old Suhani Batnagar, who played "Little Barbita" in "Daddy", due to dermatomyositis and comorbidities, has aroused widespread concern about dermatomyositis.

Dermatomyositis is a group of autoimmune diseases that primarily affect the muscles and muscles, as well as a diffuse inflammatory disease that primarily affects the striated muscles. The typical manifestation is symmetrical proximal muscle weakness of the limbs, usually accompanied by rash and other multi-organ damage, and the patient's **, kidneys, heart, lungs, etc. can be damaged to varying degrees, among which lung involvement is the most common, such as interstitial lung disease, pulmonary fibrosis, pleurisy, etc., often manifested as chest tightness, shortness of breath, cough, phlegm and dyspnea.

Laboratory tests are mainly composed of general examination, myositis antibody spectrum detection, muscle enzyme spectrum examination, etc. Typically, patients have mild anemia with an elevated erythrocyte sedimentation rate (erythrocyte sedimentation rate), elevated C-reactive protein, and elevated serum myoglobin, which can determine the degree of inflammatory activity. Elevated serum ferritin is a risk factor for acute interstitial pneumonia (ILD) in patients with dermatomyositis, which may be associated with the prognosis of dermatomyositis with acute ILD. Myositis antibodies are divided into myositis-specific antibodies and myositis-related antibodies. Myositis-specific antibodies are useful in aiding diagnosis in the absence of muscle biopsy and atypical clinical presentation, as well as in guiding ** and prognosis. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine phosphokinase were elevated in the acute phase of muscle enzyme studies, and creatine phosphokinase specificity was high. Other examinations include electromyography, muscle magnetic resonance imaging (MRI), chest CT, cardiac ultrasound, **pathology, muscle pathological examination, etc.

There is no best way to treat dermatomyositis, mainly through drugs, glucocorticoids combined with immunosuppressants, and small molecule targeted drugs are also applicable.

Dermatomyositis is not a simple disease, but an autoimmune disease. While dermatomyositis causes the most serious damage, it may also cause damage to other important organs, so remember not to ignore it and not to miss the diagnosis.

Zhongbo Xiong (Department of Clinical Laboratory, Shanghai Eighth People's Hospital).

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