Pneumomediastinum as a complication of interstitial lung disease in dermatomyositis

Neumomediastino como complicación de enfermedad pulmonar intersticial en dermatomiositis

Introduction: dermatomyositis is an idiopathic, heterogenous, inflammatory myopathy, which is difficult to diagnose. It is associated with cutaneous manifestations and is considered a variable disease in terms of clinical presentation, course, and prognosis. It may involve different organs and systems, in addition to the skin and muscles. Case report: 56-year-old patient with a history of dermatomyositis who was admitted to the emergency room with dysphagia to solids and liquids, asthenia and adynamia. A thoracic CT scan evidenced pneumomediastinum and multilobar consolidations. Symptoms improved after antibiotic management and methotrexate initiation. Discussion:  not many cases of pneumomediastinum in the context of interstitial disease associated with dermatomyositis have been described, thus studying this condition is relevant. The patient did not refer respiratory symptoms. The endoscopy study and esophageal CT scan did not reveal esophageal perforation, thus pneumologists attributed this clinical presentation to the Macklin effect. Conclusion: spontaneous pneumomediastinum is a rare complication carrying a high mortality rate, however it can occur in patients with interstitial lung disease. 

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