Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review
Ahmed Hussein Subki,1 Ibraheem Mohammed Almani,2 Abdurahman Albeity,1 Bandari Khalid Aljabri,1 Roaa Alsolaimani,1,2 Hussein Halabi1 1Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 2Department of Medicine, King Abdulaziz University Hospital, Jeddah,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-04-01
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| Series: | Journal of Inflammation Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/spontaneous-pneumomediastinum-and-subcutaneous-emphysema-in-dermatomyo-peer-reviewed-fulltext-article-JIR |
| _version_ | 1827973309318299648 |
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| author | Subki AH Almani IM Albeity A Aljabri BK Alsolaimani R Halabi H |
| author_facet | Subki AH Almani IM Albeity A Aljabri BK Alsolaimani R Halabi H |
| author_sort | Subki AH |
| collection | DOAJ |
| description | Ahmed Hussein Subki,1 Ibraheem Mohammed Almani,2 Abdurahman Albeity,1 Bandari Khalid Aljabri,1 Roaa Alsolaimani,1,2 Hussein Halabi1 1Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 2Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaCorrespondence: Ahmed Hussein Subki; Hussein Halabi, Department of Internal Medicine, King Faisal Specialist Hospital & research center, POBox: 43129, Jeddah, 21561, Saudi Arabia, Tel +966566724288, Email subki.research@gmail.com; mfasel@gmail.comBackground: Spontaneous pneumomediastinum and subcutaneous emphysema are rare and serious complications of dermatomyositis (DM).Case Presentation: Our article presents two clinically heterogeneous cases of DM who developed pneumomediastinum and subcutaneous emphysema. The first was a 24-year-old lady with a recently diagnosed DM. She developed rapidly progressive pneumonia, interstitial lung disease (ILD), pneumomediastinum, subcutaneous emphysema, and acute respiratory distress syndrome (ARDS). She died despite treatment with steroids and immunosuppressants (methotrexate and mycophenolate mofetil (MMF)). The second was a 30-year-old man diagnosed with amyopathic DM. He developed pneumomediastinum prior to ILD, which worsened over time, and subcutaneous emphysema evolved. However, he recovered completely after corticosteroid, MMF, and rituximab.Conclusion: Spontaneous pneumomediastinum and subcutaneous emphysema may complicate DM. Corticosteroids, immunosuppressants, and respiratory support are the mainstay of management for these conditions. Though they were reported to carry a poor prognostic value, the course and outcome are highly variable among the cases.Keywords: dermatomyositis, pneumomediastinum, subcutaneous emphysema, pneumothorax, corticosteroids, immunosuppressants, rituximab |
| first_indexed | 2024-04-09T19:34:00Z |
| format | Article |
| id | doaj.art-f718d6890ceb4bbab5c66ca599bb666a |
| institution | Directory Open Access Journal |
| issn | 1178-7031 |
| language | English |
| last_indexed | 2024-04-09T19:34:00Z |
| publishDate | 2023-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Inflammation Research |
| spelling | doaj.art-f718d6890ceb4bbab5c66ca599bb666a2023-04-04T20:11:33ZengDove Medical PressJournal of Inflammation Research1178-70312023-04-01Volume 161431144182754Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature ReviewSubki AHAlmani IMAlbeity AAljabri BKAlsolaimani RHalabi HAhmed Hussein Subki,1 Ibraheem Mohammed Almani,2 Abdurahman Albeity,1 Bandari Khalid Aljabri,1 Roaa Alsolaimani,1,2 Hussein Halabi1 1Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 2Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaCorrespondence: Ahmed Hussein Subki; Hussein Halabi, Department of Internal Medicine, King Faisal Specialist Hospital & research center, POBox: 43129, Jeddah, 21561, Saudi Arabia, Tel +966566724288, Email subki.research@gmail.com; mfasel@gmail.comBackground: Spontaneous pneumomediastinum and subcutaneous emphysema are rare and serious complications of dermatomyositis (DM).Case Presentation: Our article presents two clinically heterogeneous cases of DM who developed pneumomediastinum and subcutaneous emphysema. The first was a 24-year-old lady with a recently diagnosed DM. She developed rapidly progressive pneumonia, interstitial lung disease (ILD), pneumomediastinum, subcutaneous emphysema, and acute respiratory distress syndrome (ARDS). She died despite treatment with steroids and immunosuppressants (methotrexate and mycophenolate mofetil (MMF)). The second was a 30-year-old man diagnosed with amyopathic DM. He developed pneumomediastinum prior to ILD, which worsened over time, and subcutaneous emphysema evolved. However, he recovered completely after corticosteroid, MMF, and rituximab.Conclusion: Spontaneous pneumomediastinum and subcutaneous emphysema may complicate DM. Corticosteroids, immunosuppressants, and respiratory support are the mainstay of management for these conditions. Though they were reported to carry a poor prognostic value, the course and outcome are highly variable among the cases.Keywords: dermatomyositis, pneumomediastinum, subcutaneous emphysema, pneumothorax, corticosteroids, immunosuppressants, rituximabhttps://www.dovepress.com/spontaneous-pneumomediastinum-and-subcutaneous-emphysema-in-dermatomyo-peer-reviewed-fulltext-article-JIRdermatomyositispneumomediastinumsubcutaneous emphysemapneumothoraxcorticosteroidsimmunosuppressantsrituximab |
| spellingShingle | Subki AH Almani IM Albeity A Aljabri BK Alsolaimani R Halabi H Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review Journal of Inflammation Research dermatomyositis pneumomediastinum subcutaneous emphysema pneumothorax corticosteroids immunosuppressants rituximab |
| title | Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review |
| title_full | Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review |
| title_fullStr | Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review |
| title_full_unstemmed | Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review |
| title_short | Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review |
| title_sort | spontaneous pneumomediastinum and subcutaneous emphysema in dermatomyositis a case series and literature review |
| topic | dermatomyositis pneumomediastinum subcutaneous emphysema pneumothorax corticosteroids immunosuppressants rituximab |
| url | https://www.dovepress.com/spontaneous-pneumomediastinum-and-subcutaneous-emphysema-in-dermatomyo-peer-reviewed-fulltext-article-JIR |
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