Dermatomyositis Presenting as Life-threatening Hypercalcemia
10.4078/jrd.2020.27.4.285
- Author:
Harold Henrison CHIU
1
;
Patricia Pauline REMALANTE
;
Remalante NACIANCENO
;
Rogelio VELASCO JR
;
Ramon LARRAZABAL JR
;
Geraldine ZAMORA
Author Information
1. Division of Endocrinology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Publication Type:Case Report
- From:Journal of Rheumatic Diseases
2020;27(4):285-289
- CountryRepublic of Korea
- Language:0
-
Abstract:
Dermatomyositis is a rare disease characterized by classic skin lesions and muscle weakness. In rare cases, life-threatening hypercalcemia may develop caused by regression of dystrophic calcifications. Here we report a 36-year-old man who presented with progressive proximal weakness, difficulty in ambulation, and weight loss. He had the V-sign, Gottron’s papules, and hard, chalky nodules on both antecubital, thigh, and hip areas. Laboratory examinations revealed hypercalcemia (3.47 mmol/L) and shortened QT interval. Workup for malignancy and tuberculosis yielded negative results. Biopsy of the antecubital areas revealed calcinosis cutis. Serum calcium levels gradually normalized with hydration and steroids. Our case illustrated that a high index of suspicion for dermatomyositis is warranted for early diagnosis and ascertaining the etiology of hypercalcemia is vital in the management of this life-threatening complication. While hypercalcemia from dermatomyositis may respond to steroids, to date, individualization of treatment remains the standard of care.
