Dermatomyositis and Crohn's disease - Case report

Immune-mediated diseases tend to overlap in ways that are not completely understood. When a presentation is not entirely explained by a former condition, other hypotheses should arise. Additionally, the activity of 2 overlapping immune-mediated conditions is not always associated. We present an unusual association between Crohn's disease and dermatomyositis in a 28-year-old man. The patient presented with a 2-month history of proximal muscle weakness and a skin rash with heliotrope periorbital edema. Since the patient had already been diagnosed with Crohn's disease, he was under immunosuppressive therapy, and he had a family history of psoriasis, the diagnosis was not immediate and required an integrative approach. Laboratory analysis revealed elevated creatine kinase, aldolase, lactic dehydrogenase and transaminase levels. He had no symptoms of Crohn's disease exacerbation. Magnetic resonance imaging, electromyography, and muscle biopsy findings were consistent with inflammatory myopathy, although non-specific. Corticosteroids were initiated with clinical and laboratory improvement within 1 month.