皮肌炎合并恶性肿瘤和心肌病的诊治--1例多学科讨论

Diagnosis and treatment of dermatomyositis combined with malignancy and cardiomyopathy--a multi⁃disciplinary discussion

扩张型心肌病是一种异质性心肌病,自身免疫性疾病累及心肌可致继发性扩张型心肌病。本病例是1例以扩张型心肌病引发的心力衰竭为首诊症状的患者,入院以后完善相关检查,发现患者有颜面部、颈部和上臂皮疹,心脏核磁共振考虑心肌炎性病变,胸部CT示右肺门及纵隔多发肿大淋巴结,颅脑核磁共振增强示左侧小脑异常信号灶,考虑转移瘤。最终诊断为继发性扩张型心肌病、肺癌并脑转移?、皮肌炎。

Dilated cardiomyopathy is a heterogeneous cardiomyopathy,and autoimmune disease involving the heart muscle can lead to secondary dilated cardiomyopathy.This case reported a patient who first presented for symptoms of heart failure caused by dilated cardiomyopathy.After a series of related examinations in hospital,it was found that the pa-tient had skin rashes on the face,neck and upper arm.The heart MRI was considered to be myocardial inflammatory le-sions.The chest CT showed multiple enlarged lymph nodes in the right hilum and mediastinum.The enhanced brain MRI showed left cerebellum abnormal signal,considering brain metastases.Final diagnosis were secondary dilated cardiomyop-athy,lung cancer with brain metastasis?,dermatomyositis.