BÁO CÁO CA BỆNH BIẾN CHỨNG THỦNG TÁ TRÀNG TRÊN BỆNH NHÂN VIÊM DA CƠ TRẺ EM
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Abstract
Background: Juvenile dermatomyositis is an systemic autoimmune disease manifested by progressive symmetrical proximal weakness, heliotrope rash, Gottron’s papules, increased plasma muscle enzyms and an abnormal electromyogram. Gastrointestinal tract involvement in assosiated with intestinal vasculitis is less common but could be the cause of hemorrage and perforation - a life-threatening condition. Doudenal perforation has been reported in patients taking steroids and non-steroid anti-inflammatory drugs. However, its association with Juvenile dermatomyositis is extremely rare.
Case presentation: A 3 years old boy diagnosed Juvenile dermatomyositis for 1 years ago was controlled by prednisolon 1.5mg/kg/day, Methotrexate 20 mg/m2/week, Mycophenolate mofetil 1000mg/m2/day. He presented with intermittent abdominal pain, vomit, watery stool, red rash in his face, more weakness than normal, anal and armpit ulcers. Pancreatitis associated dermatomyositis associated pancreatitis was suspected and treated by steroid pulse therapy with methylprednisolone 30mg/kg/d for 3 days. His general condition improved. After 2 weeks, he had fever again, persistent abdominal pain in the right side. At that time, he was diagnosed Juvenile dermatomyositis complicated with doudenal perforation and right perineal muscle necrosis. He underwent emergency opertation and multiple peritoneal drainage. The pus culture yielded Stenotrophomonas maltophilia and Candida albican. After treated by aggressive antibiotics, his abdominal condition was stable.
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Keywords
Viêm da cơ, thủng tá tràng, đau bụng cấp, viêm mạch ruột, Juvenile dermatomyositis, duodenal perforation, acute abdominal pain, intestinal vasculitis
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