Dermatomiositis y miastenia gravis: una asociación infrecuente con implicaciones terapéuticas

Rare occurrence of central diabetes insipidus with dermatomyositis in a young male

SUMMARY

Central diabetes insipidus (CDI) and several endocrine disorders previously classified as idiopathic are now considered to be of an autoimmune etiology. Dermatomyositis (DM), a rare autoimmune condition characterized by inflammatory myopathy and skin rashes, is also known to affect the gastrointestinal, pulmonary, and rarely the cardiac systems and the joints. The association of CDI and DM is extremely rare. After an extensive literature search and to the best of our knowledge this is the first reported case in literature, we report the case of a 36-year-old male with a history of CDI, who presented to the hospital's endocrine outpatient clinic for evaluation of a 3-week history of progressive facial rash accompanied by weakness and aching of the muscles.

LEARNING POINTS

Accurate biochemical diagnosis should always be followed by etiological investigation. This clinical entity usually constitutes a therapeutic challenge, often requiring a multidisciplinary approach for optimal outcome. Dermatomyositis is an important differential diagnosis in patients presenting with proximal muscle weakness. Associated autoimmune conditions should be considered while evaluating patients with dermatomyositis. Dermatomyositis can relapse at any stage, even following a very long period of remission. Maintenance immunosuppressive therapy should be carefully considered in these patients.

Bibliometric analysis of the scientific production as regards statin use for ophthalmological symptoms of myasthenia gravis

INTRODUCTION

The first symptoms of myasthenia gravis (MG) usually involve weakness of the ocular muscles, making it relevant that ophthalmologists have updated information on studies as regards its relationship with the consumption of drugs, such as statins.

MATERIALS AND METHODS

A bibliometric analysis was performed using the Scopus database and by a search strategy in the selection of documents containing descriptors related to statins in the «Title» («TI») field and the descriptors «ophthalm *', «myast *', «visual *' in other fields of the document (period 1986-2015).

RESULTS

The results showed that, while the number of scientific publications on ocular effects of statins has grown lineally (n=838; y=2.267x-4507.1; r=0.7221; time of duplication: 4.66 years, and rate of annual growth: 50.06%), the specific publications about MG have experienced an exponential growth (n=38; y=2E-262e^0.3001x; r=0.3892; time of duplication: 2.95 years, and rate of annual growth: 46.25%) without reaching the saturation postulated in Price theory of the expansion of the scientific literature. The majority of publications relating to MG are reports of cases linked to a worsening of the MG symptoms, and simvastatin and atorvastatin are the agents mentioned in most of the publications.

CONCLUSIONS

These results should enable ophthalmologists to expand their knowledge concerning the evolution of studies on statins and MG, pointing out the relevance of such causal relationships.