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Case ReportCase Reports

Fatal Acute Interstitial Pneumonitis Complicating Polymyositis in a 41-Year-Old Man

Naim Y Aoun, Eduardo Velez, Alka Aggarwal, Gerald B Hayes and Lawrence A Kenney
Respiratory Care December 2004, 49 (12) 1515-1521;
Naim Y Aoun
Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, Brighton, Massachusetts
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Eduardo Velez
Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, Brighton, Massachusetts
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Alka Aggarwal
Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, Brighton, Massachusetts
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Gerald B Hayes
Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, Brighton, Massachusetts
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Lawrence A Kenney
Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, Brighton, Massachusetts
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Abstract

We report a case of a previously healthy 41-year-old man who was admitted for progressive dyspnea and cough, which culminated in respiratory failure, shock, and death. Lung and muscle biopsy results were consistent with interstitial lung disease secondary to polymyositis. Polymyositis and dermatomyositis are rare autoimmune diseases that primarily affect the muscles and skin, with frequent extramuscular and specifically pulmonary manifestations. Respiratory complications are in 2 categories: primary (the interstitial lung diseases, which can be acute or chronic) and secondary (aspiration pneumonia/pneumonitis, muscle weakness, infection, drug-induced disease, pulmonary congestion secondary to heart failure, pulmonary hypertension, and pneumomediastinum). Diagnosis of a specific interstitial lung disease relies mainly on high-resolution computed tomography of the chest and on tissue diagnosis. Prognosis depends on the histopathology findings and the specific form of interstitial lung disease and its response to therapy, which consists of high-dose steroids and immunomodulating agents. Unfortunately, patients with polymyositis/dermatomyositis associated with pulmonary complications have a worse prognosis than patients with isolated forms.

  • interstitial pneumonitis
  • polymyositis
  • dermatomyositis

Footnotes

  • Correspondence: Naim Y Aoun MD, Division of Pulmonary and Critical Care Medicine, Caritas Saint Elizabeth Medical Center, 736 Cambridge Street, Brighton MA 02135. E-mail: naim00{at}hotmail.com.
  • Copyright © 2004 by Daedalus Enterprises Inc.
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Respiratory Care: 49 (12)
Respiratory Care
Vol. 49, Issue 12
1 Dec 2004
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Fatal Acute Interstitial Pneumonitis Complicating Polymyositis in a 41-Year-Old Man
Naim Y Aoun, Eduardo Velez, Alka Aggarwal, Gerald B Hayes, Lawrence A Kenney
Respiratory Care Dec 2004, 49 (12) 1515-1521;

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Fatal Acute Interstitial Pneumonitis Complicating Polymyositis in a 41-Year-Old Man
Naim Y Aoun, Eduardo Velez, Alka Aggarwal, Gerald B Hayes, Lawrence A Kenney
Respiratory Care Dec 2004, 49 (12) 1515-1521;
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Keywords

  • interstitial pneumonitis
  • polymyositis
  • dermatomyositis

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