Juvenile Dermatomyositis and Extensive Calcinosis. Treatment With Methylprednisolone and Methotrexate
Dermatomiositis juvenil y calcinosis extensa. Tratamiento con metilprednisolona y metotrexato
Zoilo Morel Ayala
, Rogelio Martínez Ramírez, Samara Mendieta Zerón, Enrique Faugier Fuentes, Rocío Maldonado Velázquez
Corresponding author
zoiloma@hotmail.com
Correspondence: Departamento de Reumatología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162. Col. Doctores, Delegación Cuauhtémoc. 06720 México DF. México.
Correspondence: Departamento de Reumatología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162. Col. Doctores, Delegación Cuauhtémoc. 06720 México DF. México.
Departamento de Reumatología, Hospital Infantil de México Federico Gómez, México DF, Mexico
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Treatment With Methylprednisolone and Methotrexate" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "248" "paginaFinal" => "250" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Zoilo Morel Ayala, Rogelio Martínez Ramírez, Samara Mendieta Zerón, Enrique Faugier Fuentes, Rocío Maldonado Velázquez" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Zoilo" "apellidos" => "Morel Ayala" "email" => array:1 [ 0 => "zoiloma@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Rogelio" "apellidos" => "Martínez Ramírez" ] 2 => array:2 [ "nombre" => "Samara" "apellidos" => "Mendieta Zerón" ] 3 => array:2 [ "nombre" => "Enrique" "apellidos" => "Faugier Fuentes" ] 4 => array:2 [ "nombre" => "Rocío" "apellidos" => "Maldonado Velázquez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Reumatología, Hospital Infantil de México Federico Gómez, México DF, Mexico" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Departamento de Reumatología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162. Col. Doctores, Delegación Cuauhtémoc. 06720 México DF. México." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatomiositis juvenil y calcinosis extensa. Tratamiento con metilprednisolona y metotrexato" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-09-06" "fechaAceptado" => "2007-11-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec111947" "palabras" => array:3 [ 0 => "Dermatomyositis" 1 => "Calcinosis" 2 => "Methylprednisolone" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec111946" "palabras" => array:3 [ 0 => "Dermatomiositis" 1 => "Calcinosis" 2 => "Metilprednisolona" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Juvenile dermatomyositis (JDM) is considered a multisystemic disease of uncertain etiology. The clinical manifestation is a non-suppurative inflammation of the striated muscle, gastrointestinal tract, and skin. Dystrophic calcifications are present in 30%–70% of children with JDM.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The clinical case we are presenting is a 4 years old female with diagnosis of JDM in accordance to the Bohan and Peters criteria (very early presentation age) with extensive calcinosis, classified as functional class III, without being able to sit down or flex her knees. She was treated with IV methylprednisolone (MPS) bolus every 14 days and oral methotrexate, with improvement of her clinical condition.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Even though calcinosis is a frequent finding in connective tissue disease and can cause severe disability, there are no treatment protocols at this time. The simultaneous use of IV MPS and oral methotrexate allows for a faster control of the disease, improvement in muscular force, reduction of erythema and regression of the calcinosis without important collateral effects.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La dermatomiositis juvenil (DMJ) es una enfermedad multisistémica de etiología incierta, que resulta en una inflamación crónica no supurativa del músculo estriado, la piel y el tracto gastrointestinal. Las calcificaciones distróficas ocurren en un 30–70% de los niños con DMJ. Presentamos el caso de una paciente de 4 años de edad, con diagnóstico de DMJ según criterios de Bohan y Peter, en una edad muy temprana de presentación, con calcinosis extensas que le impedían sentarse, sin flexión de articulación de rodillas, con clase funcional 3. Recibió tratamiento con pulsos intravenosos de metilprednisolona cada 14 días, además de metotrexato vía oral, con mejoría clínica.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pesar de que la calcinosis es frecuente en enfermedades del tejido conectivo y puede llevar a discapacidad severa, no se han desarrollado protocolos terapéuticos para su manejo. El uso simultáneo de metilprednisolona y metotrexato permite un control más rápido de la enfermedad, con mejoría en la fuerza muscular y el eritema y regresión de las calcinosis, sin efectos colaterales importantes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juvenile dermatomyositis. 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| 2019 July | 2 | 0 | 2 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 4 | 0 | 4 |
| 2019 February | 1 | 0 | 1 |
| 2019 January | 4 | 0 | 4 |
| 2018 December | 1 | 0 | 1 |
| 2018 May | 2 | 1 | 3 |
| 2018 April | 25 | 19 | 44 |
| 2018 March | 29 | 23 | 52 |
| 2018 February | 17 | 7 | 24 |
| 2018 January | 11 | 7 | 18 |
| 2017 December | 15 | 10 | 25 |
| 2017 November | 10 | 11 | 21 |
| 2017 October | 12 | 7 | 19 |
| 2017 September | 11 | 8 | 19 |
| 2017 August | 9 | 11 | 20 |
| 2017 July | 13 | 9 | 22 |
| 2017 June | 32 | 12 | 44 |
| 2017 May | 32 | 19 | 51 |
| 2017 April | 17 | 6 | 23 |
| 2017 March | 24 | 10 | 34 |
| 2017 February | 6 | 5 | 11 |
| 2017 January | 9 | 3 | 12 |
| 2016 December | 41 | 19 | 60 |
| 2016 November | 19 | 9 | 28 |
| 2016 October | 27 | 8 | 35 |
| 2016 September | 21 | 8 | 29 |
| 2016 August | 18 | 7 | 25 |
| 2016 July | 14 | 8 | 22 |
| 2016 May | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 1 | 0 | 1 |
| 2015 July | 6 | 6 | 12 |
| 2015 June | 14 | 25 | 39 |
| 2015 May | 24 | 28 | 52 |
| 2015 April | 19 | 28 | 47 |
| 2015 March | 22 | 18 | 40 |
| 2015 February | 13 | 24 | 37 |
| 2015 January | 11 | 33 | 44 |
| 2014 December | 23 | 30 | 53 |
| 2014 November | 14 | 26 | 40 |
| 2014 October | 12 | 26 | 38 |
| 2014 September | 10 | 26 | 36 |
| 2014 August | 21 | 34 | 55 |
| 2014 July | 17 | 32 | 49 |
| 2014 June | 32 | 20 | 52 |
| 2014 May | 25 | 25 | 50 |
| 2014 April | 28 | 26 | 54 |
| 2014 March | 40 | 18 | 58 |
| 2014 February | 37 | 18 | 55 |
| 2014 January | 32 | 18 | 50 |
| 2013 December | 22 | 20 | 42 |
| 2013 November | 19 | 20 | 39 |
| 2013 October | 30 | 20 | 50 |
| 2013 September | 30 | 19 | 49 |
| 2013 August | 27 | 25 | 52 |
| 2013 July | 28 | 19 | 47 |
| 2013 June | 27 | 16 | 43 |
| 2013 May | 29 | 21 | 50 |
| 2013 April | 24 | 8 | 32 |
| 2013 March | 23 | 14 | 37 |
| 2013 February | 24 | 14 | 38 |
| 2013 January | 26 | 11 | 37 |
| 2012 December | 15 | 16 | 31 |
| 2012 November | 8 | 12 | 20 |
| 2012 October | 8 | 9 | 17 |
| 2012 September | 8 | 4 | 12 |
| 2012 July | 1 | 0 | 1 |
| 2012 May | 2 | 0 | 2 |
| 2012 April | 4 | 0 | 4 |
| 2012 March | 7 | 0 | 7 |
| 2012 February | 2 | 0 | 2 |
| 2012 January | 5 | 0 | 5 |
| 2011 December | 3 | 0 | 3 |
| 2011 November | 1 | 0 | 1 |
| 2011 October | 4 | 0 | 4 |
| 2011 June | 2 | 0 | 2 |
| 2011 April | 1 | 0 | 1 |
| 2011 March | 4 | 0 | 4 |
| 2011 February | 2 | 0 | 2 |
| 2011 January | 5 | 0 | 5 |
| 2010 December | 4 | 0 | 4 |
| 2010 November | 3 | 0 | 3 |
| 2010 October | 10 | 0 | 10 |
| 2010 September | 2 | 0 | 2 |
| 2010 August | 6 | 0 | 6 |
| 2010 July | 3 | 0 | 3 |
| 2010 June | 2 | 0 | 2 |
| 2010 May | 7 | 0 | 7 |
| 2010 April | 6 | 0 | 6 |
| 2010 March | 1 | 0 | 1 |
| 2010 February | 2 | 0 | 2 |
| 2010 January | 12 | 0 | 12 |
| 2009 December | 2 | 0 | 2 |
| 2009 November | 6 | 0 | 6 |
| 2009 October | 6 | 0 | 6 |
| 2009 September | 13 | 0 | 13 |
| 2009 August | 6 | 0 | 6 |
| 2009 July | 2 | 0 | 2 |
| 2009 June | 10 | 0 | 10 |
| 2009 May | 9 | 0 | 9 |
| 2009 April | 22 | 0 | 22 |
| 2009 March | 7 | 0 | 7 |
Show all
