TY - JOUR
T1 - Retinopathy in childhood dermatomyositis
AU - Harrison, Stephen M.
AU - Frenkel, Marcel
AU - Grossman, Burton J.
AU - Matalon, Reuben
N1 - Funding Information:
the upper extremities, especially on the extensor surface of the hands. The optic fundi were re-corded as normal. The lungs were clear. The heart was not enlarged ; a grade I-II/VI systolic murmur was audible at the apex and along the left sternal border. Sensorium was intact. Muscle strength of all extremities was diminished, and there was ten-derness on palpation of the quadriceps. No limita-tion of joint movement was evident. She had wad-dling gait and could not climb stairs or rise from a sitting position. Deep tendon reflexes were hypoac-tive, but equal bilaterally. Sensory examination was normal. Results of laboratory examinations—Hemoglobin was 13 g/100 ml. White blood cell count was 6,000/mm3, with a normal differential. Erythrocyte sedimentation rates were 25, 24, and 34 mm in the first hour on three occasions. The urine showed 1 + albumin with a specific gravity of 1.020 and con-tained 1 to 10 WBC per high power field. Results of blood analyses were: urea nitrogen, 12 mg/100 ml ; albumin, 5.4 g/100 ml ; globulin 2.4 g/100 ml ; carbon dioxide, sodium, potassium, calcium, and phosphorous levels were within the normal ranges. Serum glutamic oxaloacetic transaminase (SGOT) was 200 units (normal 20 to 40 units). Lactic dehy-drogenase (LDH) was 1,060 units (normal to 500 units). A month after admission, the levels of both enzymes returned to normal and remained so during the entire course of hospitalization. The 24-hour urine creatine and creatinine excretions were, re-spectively, 1,100 mg/24 hr (normal, 100 mg/24 hr) and 1,070 mg/24 hr (normal, 1,000 to 1,500 mg/24 hr). One month after admission, these levels were reduced to 82 mg/24 hr and 699 mg/24 hr. The la-tex fixation was 4+. Kahn test was negative. Electrocardiogram showed nonspecific S-T changes. The chest x-ray film was normal. Results of intermediate strength purified protein derivative and histoplasmin tests were normal. Muscle biopsy from the anterior aspect of the thigh showed inflammatory changes and necrosis compatible with the diagnosis of acute dermatomyo-sitis. On the seventh hospital day, the patient noted From the Department of Ophthalmology, Uniblurring of vision. Visual acuity in each eye was versity of Illinois Eye and Ear Infirmary, Abraham hand motion at one foot. Visual fields demonstrated Lincoln School of Medicine (Drs. Harrison and large bilateral central scotomas. Examination of the Frenkel), and the Department of Pediatrics, Unifundi revealed edema of both retinas with scattered versity of Chicago, Pritzker School of Medicine cotton-wool spots, some of which were elongated (Drs. Grossman and Matalon), Chicago, Illinois. and striate, while others were oval and round This study was supported in part by Public Health (Figs. 1 and 2). A paracentral hemorrhage was Service training grant EY-24-14 from the National present above the fight macula and a few striate Eye Institute to the University of Illinois. hemorrhages occurred in the left fundus. The large Reprint requests to Marcel Frenkel, M.D., Illivessels and optic disks were initially normal. On nois Eye and Ear Infirmary, 1855 W. Taylor St., prednisone, 60 mg daily, the exudative process deChicago, IL 60612. creased, and the patient's general condition im-
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1973/11
Y1 - 1973/11
N2 - A 16-year-old girl had bilateral visual loss due to exudative retinopathy, weakness related to a diffuse myositis, and a macular erythematous rash. Skin and muscle biopsy was compatible with the diagnosis of dermatomyositis. Although the systemic manifestations promptly resolved on corticosteroid therapy, the visual loss was permanent. Presumed vasculitis resulted in diffuse retinal changes and optic nerve atrophy. Examination eight years later revealed an arteriovenous shunt in the peripheral retina.
AB - A 16-year-old girl had bilateral visual loss due to exudative retinopathy, weakness related to a diffuse myositis, and a macular erythematous rash. Skin and muscle biopsy was compatible with the diagnosis of dermatomyositis. Although the systemic manifestations promptly resolved on corticosteroid therapy, the visual loss was permanent. Presumed vasculitis resulted in diffuse retinal changes and optic nerve atrophy. Examination eight years later revealed an arteriovenous shunt in the peripheral retina.
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U2 - 10.1016/0002-9394(73)90578-3
DO - 10.1016/0002-9394(73)90578-3
M3 - Article
C2 - 4748199
AN - SCOPUS:0015732448
SN - 0002-9394
VL - 76
SP - 786
EP - 790
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -