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484.full.pdf - cleveland clinic journal of medicine

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Japanese red cross kumamoto hospital,. kumamoto, japan. dermatomyositis-related interstitial lung disease mimicking. covid-19 pneumonia.
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Satoshi Hayano, MDDepartment of Internal Medicine,Japanese Red Cross Kumamoto Hospital,Kumamoto, JapanDermatomyositis-relatedinterstitial lung disease mimickingCOVID-19 pneumoniaA 51-year-old man with no signifi cantmedical history presented to the emer-gency department with fever and dyspnealasting for 10 days. On presentation, his bodytemperature was 36.6°C (97.9°F), respiratoryrate 15 breaths per minute, and oxygen satura-tion 90% on 1 L per minute of oxygen.On physical examination, fi ne crackleswere heard bilaterally at the base of the lungs.No evidence of muscle weakness was observed.Skin examination ( Figure 1 ) revealed Got-tron papules at the knees, elbows, and meta-carpophalangeal joints of the hands, a skinulcer at the knee, hyperkeratosis of the lateralaspect of the index finger of both hands, peri-ungual erythema, and palmar papules.Results of initial laboratory testing were asfollows:• Leukocyte count 10.7 × 10 9/L (referencerange 3.3–8.6 × 109/L)• Creatine kinase 257 IU/...