We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Anti-MDA5-Positive Dermatomyositis Presenting as Fever of Unknown Origin.
- Authors
Lee, Lori; Narang, Neera; Postolova, Anna; Seminara, Nicole; Kantor, Molly; Lee, Lori W; Narang, Neera S; Kantor, Molly A
- Abstract
Dermatomyositis is a chronic systemic autoimmune disease characterized by inflammatory infiltrates in the skin and muscle. The wide variability in clinical and serologic presentation poses a diagnostic challenge for the internist. Appreciation of the clinical variants of dermatomyositis allows for expedient diagnosis and avoidance of diagnostic error. We illustrate these challenges with the case of a 51-year-old Vietnamese-American man who initially presented with fever of unknown origin in the absence of overt skin and muscle manifestations. The diagnosis of dermatomyositis was not evident on several clinical encounters due to the absence of these hallmark symptoms. We review the variable clinical manifestations of a subtype of dermatomyositis associated with an autoantibody against melanoma differentiation-associated protein 5 (anti-MDA5) and suggest consideration of dermatomyositis as a diagnosis in patients presenting with systemic illness and markedly elevated ferritin, even in the absence of elevated muscle enzymes and classic autoantibodies.
- Subjects
DERMATOMYOSITIS; CUTANEOUS manifestations of general diseases; MYOSITIS; AUTOIMMUNE diseases; CHRONIC diseases; DIFFERENTIAL diagnosis; ETIOLOGY of diseases; FEVER; DISEASE complications
- Publication
JGIM: Journal of General Internal Medicine, 2016, Vol 31, Issue 12, p1530
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-016-3769-0