Caso clínico 1: miopatía inflamatoria idiopática. Reporte de caso, Caso clínico 2: disección de aorta. Reporte de caso

Abstract

Background: Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by muscle weakness and inflammatory infiltrates in muscle tissue, which can affect different organs. Clinical case: a 40-year-old female patient who presented with musculoskeletal pain and muscle weakness in the upper limbs accompanied by scaly papular lesions on the back of the hands and erythema on the eyelids, with increased serum muscle enzymes, suspected IIM, and a muscle biopsy was performed. Reporting perivascular infiltrate, with abnormal electromyography, the Bohan and Peter criteria are applied with a diagnosis of dermatomyositis; Immunosuppressive treatment was started with favorable clinical evolution, medical discharge and outpatient follow-up were decided Clinical case: A 40-year-old female patient who attended for musculoskeletal pain and muscle weakness in the upper limbs accompanied by scaly papular lesions on the back of the hands and erythema at the level of the eyelids, with increased serum muscle enzymes, suspected IIM, a muscle biopsy was performed reporting perivascular infiltrate , with abnormal electromyography, the Bohan and Peter criteria are applied with a diagnosis of dermatomyositis; Immunosuppressive treatment was started with favorable clinical evolution, medical discharge and outpatient follow-up were decided Conclusions: In patients presenting with musculoskeletal pain and muscle weakness associated with skin lesions, IM should be clinically suspected, so the Bohan and Peter criteria should be applied to define the diagnosis. Introducción: la disección de aorta (DA) consiste en una rotura de la capa íntima de la pared del vaso permitiendo el paso de sangre a la capa media separando la luz verdadera de la falsa, es una patología poco frecuente, que puede presentarse en pacientes con antecedentes de traumatismo torácico. Caso clínico: paciente masculino de 35 años, con antecedente de accidente en vehículo motorizado hace 18 meses, acude al servicio de emergencia por un cuadro de hemiparesia derecha más disartria de 4 horas de evolución, se realiza tomografía de cráneo sin encontrarse lesión, catalogándose como evento cerebrovascular isquémico, con recuperación neurológica espontánea, posterior presenta disnea de grandes esfuerzos, se realiza ecocardiograma reportando DA ascendente más aneurisma, se instaura tratamiento mediante medidas de soporte, con derivación para cirugía cardiotorácica. Conclusión: en pacientes con antecedentes de traumatismo torácico, debe realizárseles valoración cardiológica temprana, para detectar cuadros de DA.