Dermatomiositis

Abstract

In this degree work, it is thermal rise, asthenia, marked muscle weakness, and myalgia, all which make walking difficult described the case of a 15-year-old male patient, 4th child, born and residing in Guamote in the 24 de Mayo neighborhood, occupation: high-school student coursing the Primer Año de Bachillerato, self-identified as indigenous, language: Spanish and Quichua, Catholic religion. The patient refers a clinical picture of 1 month of evolution of facial edema, erythema heliotrope odynophagia, unquantified for him; therefore, he was taken to the Guamote hospital. The patient receives treatment for allergic reaction and is prescribed medication not specified without presenting improvement so it is brought to the Riobamba General Hospital by emergencies. Among the complementary ones that he presented at admission, leukocytosis with neutrophilia stand out, as well as elevation of markers of muscle damage such as CPK, he presented progressive paresis and disseminated lesions in the body, so electromyography is performed, by which it is diagnosed as dermatomyositis. The patient continues with dysphagia so he is sent to the third-level hospital (HCAM) for a direct laryngoscopy, however, the health staff retains the patient in the emergency area due to his poor general condition after that, paraclinical that include muscle biopsy are sent, confirming the diagnosis, however, until the result is obtained, treatment with corticosteroids and immunoglobulins is started. The patient is currently performing physiotherapy with improvement of the clinical picture and progressive recovery of muscle strength. Clinic and paraclinical should be properly assessed because there are several pathologies with similar signs and symptoms. The diagnostic test for this pathology is electromyography combined with muscle biopsy. Corticosteroids are used for the initial management of dermatomyositis either it is prednisone or methylprednisolone, these can be administered to the patient as monotherapy or with adjuvants, however the patient's response to therapy should be assessed.