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Inicio Revista Colombiana de Reumatología Complicaciones pulmonares de las miopatías inflamatorias idiopáticas: a propó...
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Vol. 16. Issue 3.
Pages 301-309 (September 2009)
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Vol. 16. Issue 3.
Pages 301-309 (September 2009)
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Complicaciones pulmonares de las miopatías inflamatorias idiopáticas: a propósito de un caso con miopatía diafragmática
Pulmonary Complications of idiopathic inflammatory myopathies: a case with myopathy of the diaphragm
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Mauricio Restrepo Escobar1, Luis Alonso González Naranjo1, Adelis Enrique Pantoja Márquez2, Luis Alberto Ramírez Gómez1, Gloria María Vásquez Duque3
1 MD, Internista, Reumatólogo, Profesor Sección de Reumatología, Facultad de Medicina, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia
2 MD, Internista, Residente de Reumatología. Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia
3 MD, PhD, Internista, Reumatóloga, Inmunóloga, Profesora Sección de Reumatología, Facultad de Medicina, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia
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Resumen

Las miopatías inflamatorias idiopáticas son el mayor grupo de miopatías adquiridas. Con base en los hallazgos clínicos, histopatológicos, inmunológicos y demográficos pueden ser diferenciadas en tres diferentes subgrupos: dermatomiositis, polimiositis y miositis por cuerpos de inclusión. El compromiso pulmonar es cada vez más reconocido como una complicación grave y una causa frecuente de morbilidad y mortalidad en estas enfermedades. Existen tres categorías de complicaciones pulmonares en miositis inflamatoria: neumonía por aspiración, hipoventilación y enfermedad pulmonar intersticial. La falla respiratoria causada por hipoventilación es una complicación poco común de las miopatías inflamatorias, la cual se presenta en pacientes con debilidad muscular generalizada e inflamación de los músculos respiratorios de inspiración y espiración. La debilidad del diafragma es probablemente una manifestación frecuente e ignorada en las miopatías inflamatorias. Reportamos el caso de una mujer con miopatía inflamatoria en quien los hallazgos de la electromiografía de músculos diafragmas demostraron compromiso inflamatorio de este músculo.

Palabras clave:
miopatías inflamatorias
polimiositis
dermatomiositis
miopatía del diafragma
Summary

The idiopathic inflammatory myopathies are the largest group of acquired myopathies. On the basis of clinical, histopathological, immunological and demographic features, they can be differentiated into three distinct subsets: dermatomyositis, polymyositis and inclusion-body myositis. Pulmonary involvement is increasingly recognized to be a serious complication and a common cause of morbidity and mortality in these diseases. There are three categories of pulmonary complications in inflammatory myositis: aspiration pneumonia, hypoventilation, and interstitial lung disease. Respiratory failure caused by hypoventilation is considered to be an uncommon complication of inflammatory myositis which occurs in patients with severe generalized muscle weakness and inflammation of inspiratory and expiratory respiratory muscles. Diaphragm weakness is frequent and probably overlooked in inflammatory myopathies. We report the case of a woman with inflammatory myopathy in whom the findings of the diaphragm muscles electromyography demonstrated inflammatory involvement of this muscle.

Key words:
inflammatory myopathies
polymyositis
dermatomyositis
myopathy of the diaphragm
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Copyright © 2009. Asociación Colombiana de Reumatología
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