Calcinosis universalis in juvenile dermatomyositis
Maryem Ferjani, Mounira El Euch
Corresponding author: Mounira El Euch, Internal Medicine Department “A”, Charles Nicolle Hospital, Tunis, Tunisia
Received: 21 Dec 2022 - Accepted: 17 Jan 2023 - Published: 24 Jul 2024
Domain: Dermatology,Internal medicine,Rheumatology
Keywords: Juvenile dermatomyositis, calcinosis, pediatrics
©Maryem Ferjani et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Maryem Ferjani et al. Calcinosis universalis in juvenile dermatomyositis. Pan African Medical Journal. 2024;48:132. [doi: 10.11604/pamj.2024.48.132.38591]
Available online at: https://www.panafrican-med-journal.com//content/article/48/132/full
Calcinosis universalis in juvenile dermatomyositis
&Corresponding author
A 5 years-old female Tunisian child was admitted in our department for inflammatory polyarthralgia, progressive limb weakness, severe muscle fatigability and fever. On physical examination she had heliotrope eyelid edema, extensive calcalreous depositis in her four extremities, trunk, abdomen and on the back with Gottron' papules. Muscle enzymes were high particularly Creatinine Phosphokinase (CPK). Electromyography showed a myogenic process and muscle biopsy revealed characteristic signs of inflammatory muscle disease. Radiographic studies revealed extensive deep muscular calcareous deposits regarding joints. Juvenile Dermatomyositis (DM) complicated with calcinosis universalis was retained. Although intensive glucocorticoids combined with methotrexate was given, the calcific nodules gradually increased in size, ulcerated frequently and restricted her joint mobility. This case illustrates en extreme rare form of calcinosis which occurs more commonly in juvenile DM than in adult DM. There is until now no successful treatment of calcinosis universalis identified to date. Few reports described successful treatment with immunoglobulins, probenecid, aluminum hydroxide, warfarin, and diltiazem. Further investigation of disease mechanisms is needed so more effective therapeutic strategies may be developed.
Figure 1: A) extensive calcareous deposits and multiple nodules in upper extremities and joints; B) calcinosis and nodules on the back