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Case Reports: Unusual presentation of more common disease/injury
Generalised oedema as a presenting manifestation of inflammatory myopathy
  1. Aritra Kumar Ray1,
  2. Poulami Karmakar2,
  3. Atanu Chandra1,
  4. Sudip Kumar Ghosh3 and
  5. Partha Sarathi Karmakar1
  1. 1Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
  2. 2Department of Internal Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
  3. 3Dermatology, Venereology, Leprosy, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
  1. Correspondence to Dr Atanu Chandra; chandraatanu123{at}gmail.com

Abstract

Polymyositis is an immune-mediated inflammatory myopathy usually presenting with weakness of proximal muscles in a symmetric pattern. Generalised subcutaneous oedema as presenting feature of inflammatory myopathy, especially polymyositis, has rarely been reported. We report here a case of a young woman who was admitted to our facility with generalised severe subcutaneous oedema. During hospital stay, she gradually developed significant proximal muscle weakness with bulbar symptoms. The initial presentation of the patient masqueraded with other causes of anasarca. However, detailed clinical features, laboratory evaluation, electromyography and muscle biopsy clinched the diagnosis of polymyositis. She was treated with systemic corticosteroids and azathioprine. The patient responded well to treatment and the swelling gradually subsided.

  • general practice / family medicine
  • immunology
  • nephrotic syndrome
  • rheumatology

http://dx.doi.org/10.1136/bcr-2021-248036

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    Footnotes

    • Contributors AC and SKG contributed to conception and initial drafting of the manuscript. AKR, PK and PSK contributed to patient management, conception, critical revision of content and final approval of manuscript. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.