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Abstract
Dermatomyositis is a inflammatory myopathy associated with interstitial lung disease in 5∼10% of cases. The oc-currence of diffuse alveolar hemorrhage (DAH) is consid-ered exceptional in the course of dermatomyositis. We ex-perienced a case of DAH in a 58-year-old female with dermatomyositis. DAH was diagnosed by anemia, infiltration on chest X-ray and computed tomography, and a bloody aspirate on bronchoscopy. Combined Pneumocys-tis jiroveci (PJP) pneumonia was suspected, as the polymerase chain reaction for PJP was positive. After intravenous the administration of immunoglobulin and treatment for the PJP, she markedly improved but subsequently developed nosocomial pneumonia and died.
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Figure 1.
On admission, a chest radiograph showed bilateral diffuse reticular haziness in panel (A). On hospital day 2, a chest radiograph showed increased haziness, especially in the left lower lung field, in panel (B), after an intravenous immunoglobulin infusion, a chest radiograph showed much improved bilateral diffuse haziness in panel (C).
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