RESUMEN
Dermatomyositis (DM) is an inflammatory myopathy often paraneoplastic in nature. Patients have characteristic cutaneous findings and possible muscle involvement. In the latter, muscle enzymes are elevated, and the electromyogram shows varied changes. Muscle or skin biopsy and myositis-specific antibodies confirm the diagnosis. Here, we report the case of an 86-year-old woman with cutaneous lesions, proximal weakness, and sicca symptoms. Muscle enzymes and electromyogram were normal. Antinuclear antibodies were elevated, and anti-TIF1γ and anti-Ro52 antibodies were positive. Muscle biopsy was compatible with the diagnosis of DM, and salivary gland biopsy confirmed Sjögren's syndrome. Malignancy investigation identified a rectal cancer, which was resected. This case illustrates a rare form of cancer presentation - anti-TIF1γ DM with normal muscle enzymes and electromyogram and concomitant secondary Sjögren's syndrome. Malignancy screening and multidisciplinary management were crucial to a successful approach.
RESUMEN
A patient with acute respiratory infection and severe hyponatraemia was admitted to our department. The hyponatraemia study was compatible with syndrome of inappropriate antidiuresis (SIAD) and an association with the respiratory problem was initially assumed. The recurrence of hyponatraemia after resolution of the pulmonary infection led to further investigation and to the diagnosis of tuberculous lymphadenitis. After treatment of this condition, discontinuation of SIAD treatment was possible, making this association presumable. We would like to highlight the importance of considering alternative conditions in the approach to SIAD.
