• 四川大學(xué)華西醫(yī)院風(fēng)濕免疫科，四川成都 610041;

目的：探討無肌病性皮肌炎的臨床特點(diǎn)。方法：回顧性分析符合Euwer提出的ADM診斷標(biāo)準(zhǔn)的5例患者的臨床資料，包括臨床癥狀體征、肌酶譜、肌電圖、肌肉病理檢查、胸部影像學(xué)檢查、治療方案。結(jié)果：所有患者均先后出現(xiàn)皮肌炎典型皮損，無肌痛或肌無力等主訴，肌酶譜、肌電圖均正常。2例抗核抗體陽性，3例有肌活檢非特異性改變，1例合并間質(zhì)性肺炎，無患者合并惡性腫瘤。結(jié)論：皮肌炎是一種復(fù)雜的綜合征，需要行全身系統(tǒng)檢查，結(jié)合肌電圖和肌肉病理檢查進(jìn)行綜合診斷。

引用本文： 羅銳,劉鋼. 5例無肌病性皮肌炎并文獻(xiàn)復(fù)習(xí). 華西醫(yī)學(xué), 2009, 24(2): 358-361. doi: 復(fù)制

1. Jorizzo J.L.Dermatomyositis：practical aspects[J].Arch Dermatol，2002，138(1)：114-6..
2. Euwer RL Sontheimer RD.Amyopathic dermatomyositis：a review[J].J Invest Dermatol，1993，100(1)：124S-127S..
3. Euwer，R.L.and R.D.Sontheimer，Amyopathic dermatomyositis(dermatomyositis sine myositis).Presentation of six new cases and review of the literature[J].J Am Acad Dermatol，1991，24(6 Pt 1)：959-966..
4. Gerami P，et al.A systematic review of adultonset clinically amyopathic dermatomyositis(dermatomyositis sine myositis)：a missing link within the spectrum of the idiopathic inflammatory myopathies[J].J Am Acad Dermatol，2006，54(4)：597-613..
5. Sato S.et al.Autoantibodies to a 140kd polypeptide，CADM140，in Japanese patients with clinically amyopathic dermatomyositis[J].Arthritis Rheum，2005，52(5)：1571-1576..
6. Sato S.Autoantibodies specifically detected in patients with polymyositis/dermatomyositis[J].Nihon Rinsho Meneki Gakkai Kaishi，2006，29(2)：85-93..
7. Yamasaki Y.et al.Unusually high frequency of autoantibodies to PL7 associated with milder muscle disease in Japanese patients with polymyositis/dermatomyositis[J].Arthritis Rheum，2006，54(6)：2004-2009..
8. Cottin V，et al.Interstitial lung disease in amyopathic dermatomyositis，dermatomyositis and polymyositis[J].Eur Respir J，2003，22(2)：245-250..
9. Kang EH,et al.Interstitial lung disease in patients with polymyositis，dermatomyositis and amyopathic dermatomyositis[J].Rheumatology(Oxford)，2005，44(10)：1282-1286..
10. Shimamoto，K.et al.Three cases of polymyositis/dermatomyositis complicated by pneumomediastinum[J].Nihon Rinsho Meneki Gakkai Kaishi，2008，31(1)：56-61..
11. Tsuda，T.et al.A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multiimmunosuppressive therapy[J].Am J Med Sci，2007，333(3)：185-190..
12. Ideura G,et al.Interstitial lung disease associated with amyopathic dermatomyositis：review of 18 cases[J].Respir Med，2007，101(7)：1406-1411..
13. Yokoyama T,et al.Fatal rapidly progressive interstitial pneumonitis associated with amyopathic dermatomyositis and CD8 T lymphocytes[J].J Intensive Care Med，2005，20(3)：160-163..
14. Kaji K,et al.A case of amyopathic dermatomyositis with acute interstitial pneumonia(DAD pattern)[J].Nihon Rinsho Meneki Gakkai Kaishi，2004，27(2)：103-107..
15. Kameda H,Takeuchi T Recent advances in the treatment of interstitial lung disease in patients with polymyositis/dermatomyositis[J].Endocr Metab Immune Disord Drug Targets，2006，6(4)：409415..
16. Miyazaki E,et al.Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(3)：436-439..
17. Nanke，Y.et al.A case of amyopathic dermatomyositis with rapidly progressive interstitial pneumonia[J].Ryumachi，2000，40(4)：705-710..
18. Callen，J.P.and R.L.Wortmann，Dermatomyositis[J].Clin Dermatol，2006，24(5)：363-73..
19. Suber，T.L.L.CasciolaRosen，and A.Rosen，Mechanisms of disease：autoantigens as clues to the pathogenesis of myositis[J].Nat Clin Pract Rheumatol，2008，4(4)：201-9..
20. elAzhary，R.A.and S.Y.Pakzad，Amyopathic dermatomyositis：retrospective review of 37 cases[J].J Am Acad Dermatol，2002，46(4)：560-5..
21. Lam WW，et al.MR imaging in amyopathic dermatomyositis[J].Acta Radiol，1999，40(1)：69-72..
22. Sugisaki，K.et al.Prevention of progression of interstitial lung lesions by early combination therapy with corticosteroids and cyclosporine/cyclophosphamide in two patients with amyopathic dermatomyositis[J].Fukushima J Med Sci，2002，48(2)：103-10..
23. Kuroda，T.et al.A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A[J].Clin Rheumatol，2003，22(1)：45-8..
24. Ohmichi，M.et al.A case of nonspecific interstitial pneumonia associated with amyopathic dermatomyositis efficiently treated with a combination of cyclosporin A and prednisolone[J].Nihon Kokyuki Gakkai Zasshi，2002，40(6)：478-83..
25. Aslanidis，S.et al.Successful treatment of refractory rash in paraneoplastic amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(7)：1198-200..
26. Iorizzo，L.J.and J.L.Jorizzo，The treatment and prognosis of dermatomyositis：an updated review[J].J Am Acad Dermatol，2008，59(1)：99-112.
  1. 1. Jorizzo J.L.Dermatomyositis：practical aspects[J].Arch Dermatol，2002，138(1)：114-6..
  2. 2. Euwer RL Sontheimer RD.Amyopathic dermatomyositis：a review[J].J Invest Dermatol，1993，100(1)：124S-127S..
  3. 3. Euwer，R.L.and R.D.Sontheimer，Amyopathic dermatomyositis(dermatomyositis sine myositis).Presentation of six new cases and review of the literature[J].J Am Acad Dermatol，1991，24(6 Pt 1)：959-966..
  4. 4. Gerami P，et al.A systematic review of adultonset clinically amyopathic dermatomyositis(dermatomyositis sine myositis)：a missing link within the spectrum of the idiopathic inflammatory myopathies[J].J Am Acad Dermatol，2006，54(4)：597-613..
  5. 5. Sato S.et al.Autoantibodies to a 140kd polypeptide，CADM140，in Japanese patients with clinically amyopathic dermatomyositis[J].Arthritis Rheum，2005，52(5)：1571-1576..
  6. 6. Sato S.Autoantibodies specifically detected in patients with polymyositis/dermatomyositis[J].Nihon Rinsho Meneki Gakkai Kaishi，2006，29(2)：85-93..
  7. 7. Yamasaki Y.et al.Unusually high frequency of autoantibodies to PL7 associated with milder muscle disease in Japanese patients with polymyositis/dermatomyositis[J].Arthritis Rheum，2006，54(6)：2004-2009..
  8. 8. Cottin V，et al.Interstitial lung disease in amyopathic dermatomyositis，dermatomyositis and polymyositis[J].Eur Respir J，2003，22(2)：245-250..
  9. 9. Kang EH,et al.Interstitial lung disease in patients with polymyositis，dermatomyositis and amyopathic dermatomyositis[J].Rheumatology(Oxford)，2005，44(10)：1282-1286..
  10. 10. Shimamoto，K.et al.Three cases of polymyositis/dermatomyositis complicated by pneumomediastinum[J].Nihon Rinsho Meneki Gakkai Kaishi，2008，31(1)：56-61..
  11. 11. Tsuda，T.et al.A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multiimmunosuppressive therapy[J].Am J Med Sci，2007，333(3)：185-190..
  12. 12. Ideura G,et al.Interstitial lung disease associated with amyopathic dermatomyositis：review of 18 cases[J].Respir Med，2007，101(7)：1406-1411..
  13. 13. Yokoyama T,et al.Fatal rapidly progressive interstitial pneumonitis associated with amyopathic dermatomyositis and CD8 T lymphocytes[J].J Intensive Care Med，2005，20(3)：160-163..
  14. 14. Kaji K,et al.A case of amyopathic dermatomyositis with acute interstitial pneumonia(DAD pattern)[J].Nihon Rinsho Meneki Gakkai Kaishi，2004，27(2)：103-107..
  15. 15. Kameda H,Takeuchi T Recent advances in the treatment of interstitial lung disease in patients with polymyositis/dermatomyositis[J].Endocr Metab Immune Disord Drug Targets，2006，6(4)：409415..
  16. 16. Miyazaki E,et al.Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(3)：436-439..
  17. 17. Nanke，Y.et al.A case of amyopathic dermatomyositis with rapidly progressive interstitial pneumonia[J].Ryumachi，2000，40(4)：705-710..
  18. 18. Callen，J.P.and R.L.Wortmann，Dermatomyositis[J].Clin Dermatol，2006，24(5)：363-73..
  19. 19. Suber，T.L.L.CasciolaRosen，and A.Rosen，Mechanisms of disease：autoantigens as clues to the pathogenesis of myositis[J].Nat Clin Pract Rheumatol，2008，4(4)：201-9..
  20. 20. elAzhary，R.A.and S.Y.Pakzad，Amyopathic dermatomyositis：retrospective review of 37 cases[J].J Am Acad Dermatol，2002，46(4)：560-5..
  21. 21. Lam WW，et al.MR imaging in amyopathic dermatomyositis[J].Acta Radiol，1999，40(1)：69-72..
  22. 22. Sugisaki，K.et al.Prevention of progression of interstitial lung lesions by early combination therapy with corticosteroids and cyclosporine/cyclophosphamide in two patients with amyopathic dermatomyositis[J].Fukushima J Med Sci，2002，48(2)：103-10..
  23. 23. Kuroda，T.et al.A case of dermatomyositis complicated with pneumomediastinum successfully treated with cyclosporin A[J].Clin Rheumatol，2003，22(1)：45-8..
  24. 24. Ohmichi，M.et al.A case of nonspecific interstitial pneumonia associated with amyopathic dermatomyositis efficiently treated with a combination of cyclosporin A and prednisolone[J].Nihon Kokyuki Gakkai Zasshi，2002，40(6)：478-83..
  25. 25. Aslanidis，S.et al.Successful treatment of refractory rash in paraneoplastic amyopathic dermatomyositis[J].Clin Rheumatol，2007，26(7)：1198-200..
  26. 26. Iorizzo，L.J.and J.L.Jorizzo，The treatment and prognosis of dermatomyositis：an updated review[J].J Am Acad Dermatol，2008，59(1)：99-112.