Hüseyin ELİK, Damla HARPUTLUOĞLU DEMİR, Rana TERLEMEZ, Figen YILMAZ, Zehra DUMAN, Kıvanç İlknur ALTUNAY, Banu KURAN

Bel ağrısı ile başvuran dermatomiyozit olgusu

Dermatomiyozit (DM), nadir görülen bağ doku hastalıklarından olup cilt lezyonları ve kas biyopsisindeki enflamatuvar değişiklikler ile karakterizedir. DM tanısı için karakteristik raşlara ilaveten proksimal kas güçsüzlüğü ve kas enzim düzeylerinin artışı gibi kriterlere gerek duyulmaktadır. Kadınlarda 2 kat fazla görülmekle birlikte, hastalığın ortaya çıkış yaşı ortalama 50 yaştır. Biz bu olgu sunumunda bel ağrısı ve bacaklarda güçsüzlük şikayeti olan kliniğimize lomber disk hernisi ön tanısı ile gönderilen bir olguyu sunmayı amaçladık. Bu yazıda, kliniğimize proksimal kas güçsüzlüğü ve bel ağrısı ile başvuran 29 yaşındaki bir olgu sunduk. Olgu nöroşirurji kliniğinden lomber disk hernisi tanısı ile kliniğimize refere edildi. Fizik muayenede dermatomiyozit için karakteristik cilt lezyonları saptandı. İğne elektromiyografi ve cilt biyopsisi sonrasında kortikosteroid tedavisi başlandı. Geç tanı konan hastalarda kaslarda yağlı değişiklik gelişmesi geri dönüşsüz kas kuvvetsizliğine ve yürüme bozukluğuna yol açabilir. Enflamasyonun erken dönemde baskılanması tedaviye dramatik yanıt almada önemlidir.

Dermatomyositis presenting with low back pain

Dermatomyositis (DM) is a rare connective tissue disease characterized by skin lesions and inflammatory changes observed in muscle biopsy findings. A definitive diagnosis of DM requires a characteristic rash in addition to proximal muscle weakness and muscle enzyme level elevation. DM is twice as common in women as men, with an age of onset of approximately 50 years. This case report describes a 29-year-old patient with low back pain and proximal muscle weakness in the legs diagnosed as lumbar disc herniation who was then referred by the neurosurgery department to our clinic. A physical examination revealed the characteristic skin lesions for dermatomyositis. Needle electromyography and a skin biopsy were performed, and corticosteroid treatment was initiated. In misdiagnosed patients, fatty infiltration in the muscles may cause irreversible weakness and gait disturbance. Early suppression of inflammation is important and can yield a dramatic response to treatment.

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