Dermatomyositis with renal involvement in a Nigerian girl

Abstract

Introduction: Juvenile dermatomyositis is a rare autoimmune muscular disorder that affects children usually less than 18 years. Common features of the disease are characteristic skin changes, calcifications within muscle groups and symmetrical proximal muscle weakness. The prevalence of this condition among Africans is unknown and only one case has been reported so far from Nigeria. We report dermatomyositis with renal involvement.
Methods: A case report of a 13 year old Nigerian girl using reports from her medical record. She presented with generalised body swelling, weakness of the limbs with inability to walk or lift herself out of bed without support and a year history of recurrent skin rashes.
Result: Findings at admission included a chronically ill girl who was mildly pale and had generalised oedema. There were multiple areas of hypopigmented macules on the face, arms, right elbow and the shoulder. Her total urine output in the first 24 hours of admission was 0.9ml/kg/hr, had a th systolic and diastolic blood pressure that was above the 95 centile for her age for. Plain radiograph of the limbs showed widespread intramuscular calcifications. She was managed conservatively with oral corticosteroid, antihypertensive and analgesics and has remained fairly stable with fewer episodes flaring of symptoms.
Conclusions: Renal involvement in juvenile dermatomyositis even though rare could be a significant clinical feature in children with this condition.

Keywords: Juvenile, dermatomyositis, renal involvement, oral corticosteroid.