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Vol. 16. Issue 4.
Pages 671-677 (July - August 2010)
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Vol. 16. Issue 4.
Pages 671-677 (July - August 2010)
Caso Clínico/Case Report
Open Access
Envolvimento pulmonar na polimiosite
Pulmonary disease in polymyositis
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Direndra Hasmucrai1, Ana Cristina Mendes2, Isabel Correia2, Teresinha Evangelista3,*, António Bugalho de Almeida4
1 Interno do complementar de Pneumologia
2 Assistente Hospitalar Graduada de Pneumologia
3 Assistente Hospitalar de Neurologia
4 Director de Serviço de Pneumologia I
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Resumo

Introdução: A polimiosite (PM) e a dermatomiosite são classificadas como miopatias inflamatórias idiopáticas. O envolvimento pulmonar por PM é pouco frequente, estando descrito na literatura em cerca de 10% de casos.

Os autores apresentam um caso de uma mulher de 75 anos, com queixas de febre, perda ponderal, artralgias, mialgias e diminuição simétrica e proximal da força muscular com impotência funcional dos membros superiores e inferiores, com início um mês antes do internamento. Apresentava infiltrados pulmonares na telerradiografia de tórax. Após estudo exaustivo estabeleceu-se o diagnóstico de envolvimento pulmonar na forma de pneumonia organizativa por PM. Efectuou-se corticoterapia e terapêutica com micofenolato com melhoria clínica, analítica e radiológica.

Conclusão: Neste caso, foi a alteração na telerradiografia de tórax numa doente sem sintomatologia respiratória que levou ao estudo exaustivo até ao diagnóstico de PM, realçando mais uma vez a importância da telerradiografia no rastreio de patologias de outros foros.

Rev Port Pneumol 2010; XVI (4): 671-677

Palavras-chave:
Polimiosite
telerradiografia do tórax
diagnóstico
prognóstico
Abstract

Introduction: Polymyositis and dermatomyositis are classified as idiopathic inflammatory myopathies. Interstitial lung disease is rare and is described in the literature in about 10% of cases.

The authors describes a case of 75 year old woman presenting with one month evolution of fever, weight loss, arthralgia, myalgia and symmetric and proximal muscle weakness of upper and lower limbs. Nonspecific interstitial changes was found in chest X-ray. After exhaustive study, the diagnosis of pulmonary envolvement in the form of organizing pneumonia by polymyositis, was established. Glucocorticoids and mycophenolate were prescribed with good clinical, analytical and radiological outcome.

Conclusion: In this case, it was the changes in the chest X-ray in a patient without respiratory sym ptomatology, that conducted to exhaustive study to polymyositis diagnosis, enhancing once again the importance of X-ray in the screaning of pathologies of other systems.

Rev Port Pneumol 2010; XVI (4): 671-677

Key-words:
Polymyositis
chest X-ray
diagnosis
prognosis
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Bibliografia
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Copyright © 2010. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
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