Modern rheumatology case reports最新文献

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Efficacy of hydroxychloroquine treatment for the skin manifestations of juvenile dermatomyositis. 羟氯喹治疗青少年皮肌炎皮肤表现的疗效观察。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf037
Asami Shimbo, Shuya Kaneko, Hitoshi Irabu, Yuko Akutsu, Yuko Hayashi, Mariko Mouri, Susumu Yamazaki, Masaaki Mori, Masaki Shimizu
{"title":"Efficacy of hydroxychloroquine treatment for the skin manifestations of juvenile dermatomyositis.","authors":"Asami Shimbo, Shuya Kaneko, Hitoshi Irabu, Yuko Akutsu, Yuko Hayashi, Mariko Mouri, Susumu Yamazaki, Masaaki Mori, Masaki Shimizu","doi":"10.1093/mrcr/rxaf037","DOIUrl":"10.1093/mrcr/rxaf037","url":null,"abstract":"<p><p>Juvenile dermatomyositis (JDM) is the most popular subtype of juvenile idiopathic inflammatory myopathies clinically characterised by skin manifestations and myositis. Some patients with JDM present predominantly with skin symptoms without significant muscle weakness. Furthermore, some patients exhibit residual skin disease even after showing improvement of muscle symptoms with systemic glucocorticoids (GCs) and immunosuppressants. Topical GCs and/or tacrolimus are recommended for the patients with skin predominant JDM. Furthermore, systemic use of GCs and methotrexate (MTX) are indicated in refractory cases. However, some patients show refractory skin disease to even systemic use of GCs and MTX. Hydroxychloroquine (HCQ) has been reported to improve skin manifestations associated with JDM and is used globally for JDM. However, HCQ is not approved by the Ministry of Health, Labour and Welfare of Japan for treatment of JDM. Herein, we report two patients with JDM presenting with residual skin disease after taking systemic GC and immunosuppressants, which was successfully treated with HCQ. HCQ was effective for treating a case with skin symptoms without significant muscle weakness at relapse and for a case with residual skin symptoms after showing improvement of muscle symptoms with systemic GCs and immunosuppressants. No adverse events were observed in their clinical courses. Thus, HCQ may be an effective choice as an adjunctive therapy for refractory skin symptom-dominant JDM.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thrombocytopenia, anasarca, fever, reticulum fibrosis, and organomegaly syndrome triggered by vaccination against SARS-CoV-2 messenger RNA vaccine. 接种SARS-CoV-2 (mRNA1273)引发的TAFRO综合征。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf042
Yuki Aizawa, Ryosuke Hanaoka, Yusuke Sakaue, Kazuhiro Kurasawa
{"title":"Thrombocytopenia, anasarca, fever, reticulum fibrosis, and organomegaly syndrome triggered by vaccination against SARS-CoV-2 messenger RNA vaccine.","authors":"Yuki Aizawa, Ryosuke Hanaoka, Yusuke Sakaue, Kazuhiro Kurasawa","doi":"10.1093/mrcr/rxaf042","DOIUrl":"10.1093/mrcr/rxaf042","url":null,"abstract":"<p><p>We describe a rare case of thrombocytopenia, anasarca, fever, reticulum fibrosis, and organomegaly (TAFRO) syndrome that developed after the second vaccination against SARS-CoV-2 (mRNA1273, manufactured by Moderna Co.) in a healthy 26-year-old male. He developed a prolonged high fever and intermittent non-localised abdominal pain soon after vaccination followed by impaired renal function and thrombocytopenia; as well as assumed cytokine storm due to serum levels of triglyceride and total cholesterol, and high serum levels of ferritin, soluble interleukin 2 receptor, soluble CD14, interleukin 6, and vascular endothelial growth factor. Based on these findings, the patient was diagnosed with TAFRO syndrome. His condition was refractory against glucocorticoid, tocilizumab, and rituximab, and temporary haemodialysis was necessary. We speculate that the mRNA vaccine triggered a modification of the immune system and caused the development of TAFRO syndrome.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Placental and breast milk transfer of belimumab in three patients with systemic lupus erythematosus treated throughout pregnancy. 妊娠期治疗的3例系统性红斑狼疮患者的胎盘和母乳移植。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf038
Akitsu Higuchi, Jumpei Saito, Kentaro Fujimori, Takashi Ishikawa, Hiroyo Kawasaki, Eiko Miyagawa, Sawako Abe, Chie Kohno, Chinatsu Takai, Yuka Sano Wada, Toshinao Kawai, Atsuko Murashima, Kayoko Kaneko
{"title":"Placental and breast milk transfer of belimumab in three patients with systemic lupus erythematosus treated throughout pregnancy.","authors":"Akitsu Higuchi, Jumpei Saito, Kentaro Fujimori, Takashi Ishikawa, Hiroyo Kawasaki, Eiko Miyagawa, Sawako Abe, Chie Kohno, Chinatsu Takai, Yuka Sano Wada, Toshinao Kawai, Atsuko Murashima, Kayoko Kaneko","doi":"10.1093/mrcr/rxaf038","DOIUrl":"10.1093/mrcr/rxaf038","url":null,"abstract":"<p><p>The safety of belimumab during pregnancy, particularly in the third trimester, remains unclear. This study aimed to assess the placental and breast milk transfer of belimumab in pregnancies complicated by systemic lupus erythematosus and to evaluate immunological effects and vaccination responses in offspring. We prospectively followed three patients with systemic lupus erythematosus who received belimumab throughout pregnancy. Belimumab concentrations were measured in maternal serum, cord blood, breast milk, and neonatal serum, along with infant development and vaccination histories. Belimumab was continued throughout pregnancy to control refractory thrombocytopenia in two cases and haemolytic anaemia in one case. All patients delivered full-term infants without obstetric complications. Overall, belimumab concentrations in cord blood and neonatal serum were comparable to those in the maternal serum, suggesting transplacental transfer. A decrease in peripheral B and transitional B cells was observed in all neonates at birth, while serum IgG levels and peripheral T cell counts were within normal ranges. Only one infant was diagnosed with a complication (left vesicoureteral reflux). Belimumab concentrations in breast milk were low, and no adverse events occurred in the vaccinated infants. Continuation of belimumab throughout pregnancy may be an option to control refractory disease activity and achieve successful outcomes in pregnancies complicated by systemic lupus erythematosus. However, careful monitoring during pregnancy and postnatal follow-up is essential to ensure safety, given that belimumab can be transferred to the placenta, detected in the neonatal peripheral blood, and affect the neonatal lymphocyte subset counts at birth.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Membranous nephropathy in ankylosing spondylitis: a rare case report. 强直性脊柱炎伴膜性肾病1例。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf049
Yin Zhao, Jing Han, Zhiqin Chen, Jinhua Liu, Jiaoyang Li, Zhongfeng Cheng
{"title":"Membranous nephropathy in ankylosing spondylitis: a rare case report.","authors":"Yin Zhao, Jing Han, Zhiqin Chen, Jinhua Liu, Jiaoyang Li, Zhongfeng Cheng","doi":"10.1093/mrcr/rxaf049","DOIUrl":"10.1093/mrcr/rxaf049","url":null,"abstract":"<p><p>Ankylosing spondylitis (AS) is a chronic inflammatory disease that typically affects the axial skeleton. Renal involvement is rare in AS, only occurring in 5-13% of AS patients. Membranous nephropathy (MN) in patients with AS is extremely rare. There have been only a few cases showing the association between MN and AS. Herein we report a case of AS-associated MN in a 47-year-old male. He was diagnosed with AS-associated MN after renal biopsy, and he was treated with corticosteroids and cyclophosphamide. His low back pain and oedema disappeared gradually and serum albumin and urine protein excretion significantly improved after treatment. In clinical practice, AS patients with proteinuria or renal dysfunction should be evaluated for MN through ‌serum anti-phospholipase A2 receptor autoantibody (anti-PLA2R antibody) testing‌ and ‌renal biopsy‌ to confirm diagnosis.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Jaccoud's arthropathy secondary to leprosy. 继发于麻风病的贾科德关节病。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae077
Izabela Prado Viana, Maria de Lourdes Castro de Oliveira Figueiroa, Beatriz Paixão Argollo, Gustavo Luiz Behrens Pinto, Mittermayer Barreto Santiago
{"title":"Jaccoud's arthropathy secondary to leprosy.","authors":"Izabela Prado Viana, Maria de Lourdes Castro de Oliveira Figueiroa, Beatriz Paixão Argollo, Gustavo Luiz Behrens Pinto, Mittermayer Barreto Santiago","doi":"10.1093/mrcr/rxae077","DOIUrl":"10.1093/mrcr/rxae077","url":null,"abstract":"<p><p>Jaccoud's arthropathy is a deforming, nonerosive form of arthritis initially described in patients with rheumatic fever. However, it has been recently observed more frequently in those with systemic lupus erythematosus. Cases of Jaccoud's arthropathy have also been described to be associated with other conditions. Herein, we describe the case of a 64-year-old Brazilian man who exhibited Jaccoud's arthropathy associated with leprosy. To the best of our knowledge, this is the first report on this association.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diffuse alveolar haemorrhage as the initial presentation of systemic lupus erythematosus possibly triggered by Rhogam injection in a 24-year-old pregnant woman: A case report. 弥漫性肺泡出血是24岁孕妇系统性红斑狼疮的首发表现,可能是罗甘注射液所致一份病例报告。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf001
Amir Khanmirzaei, Maryam Bozorgi, Gelareh Azarinoush, Fatemeh Aghaei, Asiye Bigdeli, Kimia Jazi, Akram Asghari, Maryam Masoumi
{"title":"Diffuse alveolar haemorrhage as the initial presentation of systemic lupus erythematosus possibly triggered by Rhogam injection in a 24-year-old pregnant woman: A case report.","authors":"Amir Khanmirzaei, Maryam Bozorgi, Gelareh Azarinoush, Fatemeh Aghaei, Asiye Bigdeli, Kimia Jazi, Akram Asghari, Maryam Masoumi","doi":"10.1093/mrcr/rxaf001","DOIUrl":"10.1093/mrcr/rxaf001","url":null,"abstract":"<p><p>Diffuse alveolar haemorrhage (DAH) is an uncommon and potentially life-threatening occurrence in systemic lupus erythematosus, involving bleeding into the alveolar space caused by the disruption of the alveolar capillary basement membrane. We present a 24-year-old Persian woman with a complaint of progressively worsening shortness of breath following the administration of intramuscular Rhogam after 3 days. According to her worsening clinical condition, the pregnancy was terminated. She was admitted to the intensive care unit and intubated. Simultaneously, she developed fungal and bacterial pneumonia tolerant to therapies. After several investigations, the patient was finally diagnosed with systemic lupus erythematosus along with DAH, as the first presentation of the disease. This is the first case of a pregnant woman experiencing DAH as a lupus flare following Rhogam injection. Clinicians should be aware of the mimicry nature of lupus and the importance of immune reactions in these patients.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of anti-SAE antibody-positive dermatomyositis presenting with preceding panniculitis as the initial symptom. 抗sae抗体阳性皮肌炎1例,首发症状为泛膜炎。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf029
Erika Horimoto, Jun Ishizaki, Jun Muto, Satoshi Yoshida, Kenta Horie, Daisuke Hiraoka, Hitoshi Yamasaki, Takuya Matsumoto, Koichiro Suemori, Hitoshi Hasegawa, Katsuto Takenaka
{"title":"A case of anti-SAE antibody-positive dermatomyositis presenting with preceding panniculitis as the initial symptom.","authors":"Erika Horimoto, Jun Ishizaki, Jun Muto, Satoshi Yoshida, Kenta Horie, Daisuke Hiraoka, Hitoshi Yamasaki, Takuya Matsumoto, Koichiro Suemori, Hitoshi Hasegawa, Katsuto Takenaka","doi":"10.1093/mrcr/rxaf029","DOIUrl":"10.1093/mrcr/rxaf029","url":null,"abstract":"<p><p>Myositis-specific autoantibodies found in dermatomyositis (DM) are associated with clinical symptoms and responses to therapy and are useful for diagnosis, treatment selection, and prognostication. Although the prevalence of anti-small ubiquitin-like modifier-activating enzyme (anti-SAE) antibodies in DM patients is low, clinical features such as skin symptoms preceding muscle symptoms and a higher incidence of dysphagia and malignancy have been reported. Herein, we present a case of anti-SAE antibody-positive DM in which panniculitis of the lower legs, a rare dermatological manifestation of DM, preceded muscle symptoms by 2 months. This case was associated with cervical cancer; however, the clinical course of DM was favourable with glucocorticoid monotherapy. Anti-SAE antibody-positive DM needs to be considered as a differential diagnosis of unexplained panniculitis without muscle symptoms.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Muscle vasculitis in patients with polymyalgia rheumatica: Three case series. 风湿性多肌痛患者的肌肉血管炎三个案例系列。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae072
Haruka Moriya, Yuichiro Fujieda, Yuta Inoue, Kenichi Miyamoto, Mamiko Anada, Daiki Tanaka, Akihiko Kudo, Megumi Abe, Azusa Nagai, Ryo Hisada, Michihito Kono, Masaru Kato, Olga Amengual, Yoshihiro Matsuno, Ichiro Yabe, Tatsuya Atsumi
{"title":"Muscle vasculitis in patients with polymyalgia rheumatica: Three case series.","authors":"Haruka Moriya, Yuichiro Fujieda, Yuta Inoue, Kenichi Miyamoto, Mamiko Anada, Daiki Tanaka, Akihiko Kudo, Megumi Abe, Azusa Nagai, Ryo Hisada, Michihito Kono, Masaru Kato, Olga Amengual, Yoshihiro Matsuno, Ichiro Yabe, Tatsuya Atsumi","doi":"10.1093/mrcr/rxae072","DOIUrl":"10.1093/mrcr/rxae072","url":null,"abstract":"<p><p>Polymyalgia rheumatica (PMR) is a common inflammatory disorder characterized by myalgia/stiffness in proximal hip and shoulder girdle, elevated C reactive protein, and erythrocyte sedimentation rate, but its pathogenesis is not fully elucidated. We report three cases of PMR who do not respond adequately to standard treatment. Those patients had typical symptoms of myalgia and muscle weakness, with elevated C reactive protein in absence of creatine kinase elevation. Muscle specimen showed the findings of vasculitis in all cases; therefore, muscular-limited vasculitis may be an underlying pathology in PMR in those refractory cases.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Imaging using diffusion-weighted whole-body imaging with background signal suppression for methotrexate-associated lymphoproliferative disorder: A case report. 甲氨蝶呤相关淋巴细胞增生性疾病的扩散加权全身成像背景信号抑制1例报告。
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae078
Takeshi Mochizuki, Naoko Otani, Mari Ando, Ryo Hiroshima, Koichiro Yano, Katsunori Ikari, Ken Okazaki
{"title":"Imaging using diffusion-weighted whole-body imaging with background signal suppression for methotrexate-associated lymphoproliferative disorder: A case report.","authors":"Takeshi Mochizuki, Naoko Otani, Mari Ando, Ryo Hiroshima, Koichiro Yano, Katsunori Ikari, Ken Okazaki","doi":"10.1093/mrcr/rxae078","DOIUrl":"10.1093/mrcr/rxae078","url":null,"abstract":"<p><p>Patients with rheumatoid arthritis (RA) receiving immunosuppressive therapy including methotrexate (MTX) are at risk of developing lymphoproliferative disorder (LPD). Herein, we report the case of a 61-year-old man who has been treated with MTX and sulfasalazine for seropositive RA since the age of 52 years. He underwent diffusion-weighted whole-body imaging with background signal suppression (DWIBS), which revealed high-intensity lesions in the affected lymph nodes of the cervical, clavicular, and axillary regions. Follow-up DWIBS after MTX withdrawal showed the suppression or disappearance of the high-intensity lesions. This case demonstrates the potential of DWIBS as a new standard imaging modality for MTX-LPD in patients with RA in clinical practice.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Refractory skin ulcers and afebrile bacteraemia with Staphylococcus aureus in antimelanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report. 抗黑色素瘤分化相关基因5抗体阳性皮肌炎伴金黄色葡萄球菌难治性皮肤溃疡和发热菌血症1例报告
IF 0.9
Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae082
Tokio Katakura, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Hiroshi Fujii
{"title":"Refractory skin ulcers and afebrile bacteraemia with Staphylococcus aureus in antimelanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report.","authors":"Tokio Katakura, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Hiroshi Fujii","doi":"10.1093/mrcr/rxae082","DOIUrl":"10.1093/mrcr/rxae082","url":null,"abstract":"<p><p>Skin ulcers sometimes appear in patients with antimelanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM) and are usually associated with disease activity. Here, we report a case of a 41-year-old woman with anti-MDA5 antibody-positive DM, who developed refractory skin ulcers during the remission induction therapy, which were proven to be associated with clinically silent Staphylococcus aureus bacteraemia with septic thrombi in her lung. The patient was referred to our hospital for the treatment of amyopathic DM with interstitial lung disease. Anti-MDA5-positive DM was diagnosed, and she was treated with triple therapy combined with tofacitinib because poor prognostic factors existed. Although the remission induction therapy improved most of the symptoms, she developed erythematous rashes with ulcers on her left auricle and forearm, which were refractory to topical immunosuppressive medications. Despite the absence of systemic symptoms or elevated inflammatory markers, blood and wound cultures revealed S. aureus, and a new cavitary lesion was detected in her left lung. Subsequent antibiotic therapy resolved both the cutaneous and pulmonary lesions. This case highlights the importance of considering bacteraemia and performing blood cultures when DM-related skin ulcers resist conventional treatments, even without fever during immunosuppressive therapy.</p>","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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