SHM Converge Scientific Abstract ePoster Gallery-More Than Skin Deep: Dermatomyositis With Severe Gastrointestinal Manifestations

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This case describes a 63-year-old man with new-onset idiopathic dermatomyositis who presented with progressive proximal muscle weakness, rash, and worsening dysphagia. Initial treatment with IVIG, high-dose steroids, and PEG tube placement was required because of severe swallowing dysfunction. Despite therapy, he later returned with vomiting and aspiration pneumonia as dysphagia progressed.<br /><br />During hospitalization, he had marked proximal weakness, characteristic erythematous skin findings, and severe gastrointestinal disease on endoscopy. Multiple EGDs showed extensive non-bleeding ulcers and severe inflammation throughout the esophagus, stomach, and duodenum, eventually progressing to deep cratered ulcers with friable, actively oozing mucosa. Infectious causes such as CMV, HSV, and adenovirus were negative, and gastrin was normal, supporting dermatomyositis-related GI involvement rather than another ulcerative disorder.<br /><br />The poster emphasizes that dermatomyositis is a rare inflammatory myopathy classically associated with muscle weakness and rash, but it can also affect other organs, including the GI tract. Dysphagia is relatively common, but severe malnutrition, aspiration, mucosal ulceration, and perforation are rare and may signal serious disease. Adult cases of GI ulceration are uncommon and often have poor outcomes.<br /><br />Key takeaways are that early endoscopy may help identify mucosal involvement in dermatomyositis, and clinicians must carefully balance the benefits and risks of immunosuppression, especially in critically ill patients with significant GI complications.

Asset Subtitle

Joanna Jiang

Meta Tag

Author List Joanna Jiang, Melanie N. Prestidge

Category Clinical Vignettes

Concept Dermatomyositis

Concept Swallowing Impairment

Concept Gastrointestinal Tract

Concept Gastrointestinal Ulceration

Concept Gastrointestinal Perforation

Distinguished Non-Finalist

Presenter Organization Ohio State Wexner Medical Center

Presenting Author Joanna Jiang

Track Adult

Keywords

dermatomyositis

dysphagia

proximal muscle weakness

aspiration pneumonia

gastrointestinal ulceration

esophagitis

gastritis

duodenitis

IVIG

high-dose steroids

Dermatomyositis

Swallowing Impairment

Gastrointestinal Tract

Gastrointestinal Ulceration

Gastrointestinal Perforation