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本文报告2例同卵双生儿在病毒感染2周后发生儿童型皮肌炎(DM)。例1:女、12岁,因呼吸道感染伴低热2周后感肢体无力,5周后肌无力加重,并伴肌痛、吞咽和发音困难;面颊、鼻梁、前臂伸侧及掌指关节红色斑疹。体查:颧部以上部位有红色斑丘疹及色素减退斑。肌无力以近端明显,不能行走,Gower氏征(+),深腱反射存在。余体查及神经检查正常。血清CK12000IU/ml(正常8～132),LDH532IU/ml(正常80～200),SGOT142IU/ml(正常4～40),ESR24mm/h。肌电图:插入电位增高,静止时有轻度肌纤颤及正相波,以及多相、短时限低振幅的运动电位。神经传导速度正常。股四头肌病检可见形态不一,有散在坏死及空泡形成,肌束周围的小纤维有虫蚀现象,血管及肌束衣周围有大量炎性细胞积聚。给予强的松60mg/d治疗,2周后肌
This article reports two cases of identical twins in children infected with dermatomyositis (DM) after 2 weeks. Example 1: Female, 12 years old, weakness due to respiratory infection with fever 2 weeks later, aggravation of muscle weakness after 5 weeks, with myalgia, difficulty swallowing and pronunciation; cheek, bridge of nose, forearm extensor and metacarpophalangeal red spot rash. Physical examination: the area above the zygomatic red rash and hypopigmentation spots. Muscle weakness to the proximal obvious, can not walk, Gower’s sign (+), deep tendon reflex exists. Remaining body check and nerve examination was normal. Serum CK12000IU / ml (normal 8 ~ 132), LDH532IU / ml (normal 80 ~ 200), SGOT142IU / ml (normal 4 ~ 40), ESR24mm / h. EMG: Insertion potential increased, resting mild fibrillation and normal phase wave, and multiphase, short-term low amplitude motor potential. Nerve conduction velocity is normal. Quadriceps quadriceps syndrome can be seen in different forms, scattered in the formation of necrosis and vacuoles, small fibers around the muscle bundles have worm-eaten phenomenon, blood vessels and muscle bundle around a large number of inflammatory cell accumulation. Give prednisone 60mg / d treatment, 2 weeks after the muscle