Systemic Myopathies and their Complications

Department of Internal Medicine, Fatebenefratelli-Madonna del Buon Consiglio Hospital, Naples, Italy Department of Anesthesia and Resurrection, Fatebenefratelli-Madonna del Buon Consiglio Hospital, Naples, Italy

Posters & Accepted Abstracts: Health Sci J

Abstract:

Background: Idiopathic inflammatory myopathies (IIMs) are a systemic heterogeneous autoimmune disease [1], characterized by astheny, proximal muscle pain, skin manifestations and increase of myolysis markers. We here report a case in which damages of muscles induced different scenarios and modified the outcome of the disease.

Case History: E.F. is a 21-years-old woman patient, that come in emergency room in January 2021 for limbs pain, inability to walk, dysphagia, and skin lesions. At blood sampling: increase of myolysis markers. The first diagnosis was: Rhabdomyolysis. We found increase of ANA-Ab and erythrocyte sedimentation rate (ESR). The first diagnosis was IIMs, with a prediction score>8(EULAR-ACR-2017 [2]). At the time of discharge, she started an immunosuppressive therapy. In April 2021, E.F. came back for abdominal pain. The diagnosis was ischemic duodenal perforation, and she was treated in surgery first and then in intensive care unit. She was treated with IgG-Ab 0.6g/kg/day and Prednisone therapy was stopped. During the hospitalization she also experienced aspiration pneumonia. Blood culture was positive for MDR-Acinetobacter. After 8 weeks of hospitalization, she started a physiotherapy.

Discussion: IIMs attacks all type of tissue, even smooth muscle. So, the clinical scenario may differ in different stage of disease. Complications may occur, as infective diseases, due to immunodepressed state of long-term treatment

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