Article Figures & Data
Figures
- Figure 1
- Appearance of multiple violaceous oval and round macules and plaques on the patient’s face and upper limbs.
Tables
Parameters At the time of diagnosis Two months after treatment Reference range Hematology Hgb (g/dl) 12.5 13.9 13-18 WBC (103/µl) 3.41 4.2 4-11 Lymphocytes (103/µl) 0.810 1.4 1.5-4 Platelets (103/µl) 99 193 150-450 Chemistry Creatinine (µmol/L) 69 61 71-115 BUN (mmol/L) 4.6 7 2.5-6.4 CK 9697 30 39-308 AST 517 27 15-37 Serum troponin 0.1302 - <0.026 Albumin (g/L) 20 36 34-50 Serology ANA (homogeneous) 1:320 - Negative Anti-Mi-2 Negative Negative Anti-Jo-1 Negative Negative Anti-RNP Negative Negative Anti-ds-DNA Negative - Negative HIV (ELISA) Negative Negative CRP 41 0.5 <6 ESR 18 10 <15 (male) 24-Hour urinary albumin <0.300 - <0.300 Tumor markers Total PSA (ng /ml) 2.1 0-4 CA19-9 (U/mL) <7.76 0-37 CEA (ng/mL) 1.98 0-5 Hgb: hemoglobin, WBC: white blood cell, BUN: blood urea nitrogen, CK: creatinine kinase, AST: aspartate aminotransferase,ANA: antinuclear antibody, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate - Table 2
- Timeline of the outcomes of our patient from the initial visit to the treatment and follow-up visits.
Date History/intervention/outcomes November 22, 2018 Presented to the emergency room with proximal myopathy, skin rashes, and dysphagia. He was admitted to the medical ward November 23, 2018 Magnetic resonance imaging of the thighs, electromyography, pulse therapy of intravenous methylprednisolone at a dose of 1 g once daily for 3 days November 24, 2018 Muscle biopsy November 26, 2018 Oral prednisolone at a dose of 60 mg once daily November 27, 2018 Discharge home December 9, 2018 Oral azathioprine at a dose of 50 mg once daily December 15, 2018 Free from symptoms with normalization of muscle enzyme levels December 21, 2018 New skin lesions appeared; thus, azathioprine was discontinued. Oral prednisolone was titrated until 5 mg once daily, and skin biopsy was performed January 1, 2019 Chemotherapy started (a total of 16 sessions) November 30, 2019 There were no more skin lesions and no muscle weakness; thus, prednisolone was discontinued gradually August 30, 2020 In the follow-up assessment at the rheumatology clinic, physical examination and blood test showed normal findings
