Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by symmetrical and predominantly proximal muscle weakness in the limbs, associated with typical skin lesions. Autoimmune diseases have already b...Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by symmetrical and predominantly proximal muscle weakness in the limbs, associated with typical skin lesions. Autoimmune diseases have already been described as an adverse effect of vaccines. Case-report: A 65-year-old Caucasian female patient evolved, 5 days after the first dose of the AZD1222 vaccine against the COVID-19 virus, with skin lesions suggesting heliotrope and Gottron’s sign, with partial improvement of the condition with use of topical glucocorticoids in the lesions. After two months, the patient received the second dose of AZD1222 vaccine, and evolved with proximal muscle weakness of upper and lower limbs, dysphagia, increase of muscle enzymes, in addition to skin lesions compatible with heliotrope and Gottron’s sign again. After treatment with pulse therapy with methylprednisolone 1000 mg per day for three days and treatment with immunosuppressants, she evolved with significant clinical improvement. Conclusions: This case-report demonstrating an important chronological relationship between dermatomyositis and the vaccine AZD1222 alerts to the possibility of the disease as an important adverse reaction of vaccine against COVID-19 virus, as has been recently described by other authors.展开更多
Transcranial direct current stimulation (tDCS) has emerged as a nonpharmacological tool in physical rehabilitation. There have currently no studies that evaluated the safety and efficacy of tDCS in patients with derma...Transcranial direct current stimulation (tDCS) has emerged as a nonpharmacological tool in physical rehabilitation. There have currently no studies that evaluated the safety and efficacy of tDCS in patients with dermatomyositis. Case-report: Three adult women with dermatomyositis were allocated randomly to intervention (i-tDCS, one patient) or not (sham-tDCS, two patients) of three consecutive days of tDCS and evaluated in four periods: before-tDCS (PRE), 15 minutes after-tDCS (0th POST), 15 days after-tDCS (15th POST), and 30 days after-tDCS (30th POST). The tDCS was safe throughout the protocol, without disease relapsing or adverse effects related to tDCS. Furthermore, the tDCS increased the muscle torque and total work of dominant and non-dominant elbow flexors in the patient with i-tDCS, when compared to two patients with sham-tDCS. Conclusions: The tDCS was safe and appeared to influence long-term strength in the limb of the patient with stable dermatomyo-sitis.展开更多
文摘Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by symmetrical and predominantly proximal muscle weakness in the limbs, associated with typical skin lesions. Autoimmune diseases have already been described as an adverse effect of vaccines. Case-report: A 65-year-old Caucasian female patient evolved, 5 days after the first dose of the AZD1222 vaccine against the COVID-19 virus, with skin lesions suggesting heliotrope and Gottron’s sign, with partial improvement of the condition with use of topical glucocorticoids in the lesions. After two months, the patient received the second dose of AZD1222 vaccine, and evolved with proximal muscle weakness of upper and lower limbs, dysphagia, increase of muscle enzymes, in addition to skin lesions compatible with heliotrope and Gottron’s sign again. After treatment with pulse therapy with methylprednisolone 1000 mg per day for three days and treatment with immunosuppressants, she evolved with significant clinical improvement. Conclusions: This case-report demonstrating an important chronological relationship between dermatomyositis and the vaccine AZD1222 alerts to the possibility of the disease as an important adverse reaction of vaccine against COVID-19 virus, as has been recently described by other authors.
基金Fundacao de Amparo a Pesquisa do Estado de Sao Paulo(FAPESP)#2019/12155-5 to RGMConselho Nacional de Desenvolvimento Cientifico e Tecnologico(CNPq)303379/2018-9 to SKSFaculdade de Medicina da USP to SKS.
文摘Transcranial direct current stimulation (tDCS) has emerged as a nonpharmacological tool in physical rehabilitation. There have currently no studies that evaluated the safety and efficacy of tDCS in patients with dermatomyositis. Case-report: Three adult women with dermatomyositis were allocated randomly to intervention (i-tDCS, one patient) or not (sham-tDCS, two patients) of three consecutive days of tDCS and evaluated in four periods: before-tDCS (PRE), 15 minutes after-tDCS (0th POST), 15 days after-tDCS (15th POST), and 30 days after-tDCS (30th POST). The tDCS was safe throughout the protocol, without disease relapsing or adverse effects related to tDCS. Furthermore, the tDCS increased the muscle torque and total work of dominant and non-dominant elbow flexors in the patient with i-tDCS, when compared to two patients with sham-tDCS. Conclusions: The tDCS was safe and appeared to influence long-term strength in the limb of the patient with stable dermatomyo-sitis.
