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Letter
Dermatomyositis in a patient with adenocarcinoma of the gall bladder
  1. G Yiannopoulos1,
  2. P Ravazoula2,
  3. N Meimaris1,
  4. M Stavropoulos3,
  5. A P Andonopoulos1
  1. 1Division of Rheumatology, Department of Medicine, University of Patras School of Medicine, Patras, Greece
  2. 2Department of Pathology, University of Patras School of Medicine
  3. 3Department of Surgery, University of Patras School of Medicine
  1. Correspondence to:
    Professor A P Andonopoulos, Division of Rheumatology, Department of Medicine, University of Patras School of Medicine, 265 00 Rio, Patras, Greece;
    andandon{at}med.upatras.gr

https://doi.org/10.1136/ard.61.7.663

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    A case of dermatomyositis in an elderly woman, found to have gall bladder adenocarcinoma, is presented. As far as we know this is the first report of an association between the myopathy and this specific malignancy.

    CASE REPORT

    A 75 year old white woman was admitted to our department, with a seven month history of proximal muscle weakness, dysphagia, dysphonia, facial erythema, and oedema of the eyelids. Atypical dyspeptic symptoms had been present for the same time period. At that time, an abdominal ultrasound showed, besides multiple gall stones, increased echogenicity of the gall bladder content. Simultaneous routine laboratory tests were normal, except for a minimal increase of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and a creatine kinase (CK) value of 350 IU/ml (upper normal 190). Apparently, that had gone unnoticed, until her admission.

    On physical examination, she was found to be a relatively obese elderly woman, in no distress, with normal vital signs. A “heliotrope” rash was present in her eyelids, and Gottron's papules …

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