1/8. polymyositis presenting as a neck mass.polymyositis is a rare disease entity belonging to the class of enigmatic disorders known as the collagen vascular diseases. It is characterized by proximal muscle weakness. More than 50% of the patients with this disease have development of head and neck manifestations, most commonly a heliotrope rash or dysphagia. Weakness and atrophy of neck muscles, and lolling of the neck have also been described. We report a case of polymyositis presenting as a neck mass, a heretofore undescribed manifestation of this disease in the head and neck. A review of the literature and an interdisciplinary approach to the diagnosis and management of this unusual disease will be described.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/8. The eosinophilia-myalgia syndrome with neuritis associated with L-tryptophan use.Causes of the eosinophilia-myalgia syndrome other than L-tryptophan include parasitic myositis (that is, trichinosis), acute tropical myositis, sarcoidosis, granulomatous myositis, polymyositis, collagen vascular diseases, neoplastic myositis, and eosinophilic myositis. Some of these can be excluded by the absence of associated findings, that is, sarcoidosis, collagen vascular disease, neoplastic myositis; or on epidemiologic grounds, for example, acute tropical myositis. A muscle biopsy is diagnostic for trichinosis and for granulomatous, neoplastic, and eosinophilic myositis. A normal erythrocyte sedimentation rate militates against but does not rule out neoplastic or collagen vascular disease-associated myositis. The erythrocyte sedimentation rate may be elevated in most of these disorders although trichinosis is characterized by a very low rate. Most conditions associated with eosinophilia are characterized by both blood and local tissue eosinophilia.- - - - - - - - - - ranking = 3keywords = vascular disease (Clic here for more details about this article) |
3/8. Successive unfolding of two different collagen vascular diseases in the same patient.Genetic factors may be important in the development of autoimmune disease. We describe the development of fulminant systemic lupus erythematosus in a patient 5 years after recovery from polymyositis. The successive unfolding of different autoimmune diseases in the same individual is suggestive of sequential gene activation.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
4/8. Pulmonary and neuromuscular complications of mixed connective tissue disease: a report and review of the literature.We report a 34-year-old woman with mixed connective tissue disease (MCTD) who developed severe pulmonary and neuromuscular complications. At presentation, pulmonary function tests and pulmonary mechanics were suggestive of pulmonary vascular disease, and she subsequently developed clinical signs of pulmonary hypertension. These noninvasive tests may be useful in the timing of more invasive hemodynamic studies. She initially had myasthenia gravis and then developed polymyositis, profound peripheral neuropathy, and ventilatory muscle failure. She died despite aggressive immunosuppressive therapy and plasmapheresis. autopsy showed spinal cord changes secondary to a peripheral neuropathy and signs of neurogenic atrophy confined to the ventilatory muscles. Peripheral neuropathy may be an important cause of ventilatory muscle weakness that can be found in MCTD and systemic lupus.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/8. Inclusion body myositis: a case with associated collagen vascular disease responding to treatment.patients with inclusion body myositis demonstrate characteristic histological and electronmicroscopical abnormalities in muscle and are generally considered refractory to treatment. A patient with inclusion body myositis is described with evidence of associated autoimmune disease, who responded to steroids.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
6/8. Pulmonary hypertension in polymyositis.Pulmonary hypertension is an uncommon but lethal complication of polymyositis. A 69-year-old woman is described who had a 20-month history of polymyositis and cardiac failure and in whom severe pulmonary hypertension was noted terminally when she was first seen at our clinic. She died within 24 hours of admission, and autopsy revealed severe plexogenic pulmonary vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/8. Acute and late reactions to radiation therapy in patients with collagen vascular diseases.BACKGROUND. A commonly held belief is that patients with collagen vascular diseases (CVD) have a greater risk of radiation therapy complications than patients without CVD. This impression is based on anecdotal reports, however. methods. A group of 61 patients with CVD were compared with a matched control group of 61 patients without CVD. The CVD group included 39 patients with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), 4 with systemic sclerosis (scleroderma) (SSc), 4 with dermatomyositis, and 1 with polymyositis. The control group was matched with respect to age, sex, tumor site and histologic characteristics, treatment aim, general treatment method, radiation therapy technique, site irradiated, radiation dose, date of treatment, and follow-up. RESULTS. overall, there was no significant difference between the CVD and control groups in terms of acute (11% versus 7%, respectively) or late complications (10% versus 7%, respectively). This was also true when only patients who were treated definitively were considered. Furthermore, none of the patients treated palliatively had complications. Three patients in the CVD group had fatal complications, compared with none in the control group. RA was associated with a slight increase in late complications in the definitively treated patients, whereas SLE was associated with a slight increase in acute reactions. No significant acute or late reactions were observed in the patients with SSc, dermatomyositis, or polymyositis. CONCLUSIONS. In general, these differences are less than expected and not statistically significant. Consequently, from these data, the authors could not show a significant increase in radiation therapy complications for patients with CVD.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/8. vasculitis with urticaria, hypocomplementemia, and multiple system involvement.A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple system involvement including arthralgias, glomerulonephritis, myositis, pseudotumor cerebri, and adenopathy. Persistent hypocomplementemia is noted with classic pathway activation. The syndrome recognized in this patient and those few individuals reported previously seems to constitute a distinct category of collagen-vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |