Rapidly Deteriorating Dysphagia Complicating Steroid - Resistant Dermatomyositis Successfully Treated with Intravenous - Immunoglobulin

Dermatomyositis typically presents with proximal myopathy and skin rash. Dysphagia is not an uncommon feature. Here we describe a middle aged Bangladeshi man, who presented with facial puffiness and erythema, photosensitivity, polyarthritis and proximal myopathy. Diagnostic work-up confirmed dermatomyositis. Malignancy and other connective tissue diseases were excluded. The patient did not respond to conventional immunosuppressive agents, rather deterioration occurred to involve pharyngeal and respiratory muscles. He required transfer to intensive care unit, mechanical ventilation and tracheostomy. His symptoms improved with intravenous-immunoglobulin. Bangladesh Crit Care J March 2015; 3 (1): 33-35