Abstract:
Inflammatory myopathies are a rare group of disorders that can cause significant disruption in the ability of an individual to adequately perform activities of daily living. In this case report, we present a case of a girl presenting with a substantial compromise of her ambulation with a muscle biopsy consistent with myonecrosis. She was subsequently diagnosed with an inflammatory myopathy and started on glucocorticoid and methotrexate therapy with minimal symptomatic improvement. Further in her clinical course, hypocalcemia and an undetectable 25-hydroxyvitamin D level were detected. Prompt institution of calcium and vitamin D supplementation significantly improved her myopathic condition. While there is evidence in the literature linking vitamin D deficiency with myopathy, there is a lack of data on the association between hypocalcemia and vitamin D deficiency with myonecrosis, which could represent comorbid states in myonecrosis. Therefore, vitamin D status should be established in all patients with myonecrosis, as vitamin D deficiency is easy to diagnose and treat, as exemplified in our patient\'s case, which shows that such treatment could lead to significant clinical improvement.
摘要:
炎性肌病是一组罕见的病症,其可导致个体充分进行日常生活活动的能力的显著破坏。在这个案例报告中,我们介绍了一个女孩的情况,她的行走与肌肉活检一致,与肌坏死表现出实质性的妥协。随后,她被诊断为炎症性肌病,并开始接受糖皮质激素和甲氨蝶呤治疗,症状改善最小。在她的临床过程中,检测到低钙血症和未检测到的25-羟维生素D水平.及时补充钙和维生素D的机构显着改善了她的肌病状况。虽然文献中有证据表明维生素D缺乏与肌病有关,缺乏关于低钙血症和维生素D缺乏与心肌坏死之间关联的数据,这可能代表了心肌坏死的共病状态。因此,维生素D的状态应该建立在所有的肌坏死患者,因为维生素D缺乏很容易诊断和治疗,正如我们病人的案例所例证的那样,这表明这种治疗可以导致显著的临床改善。