Juvenile dermatomyositis presenting as complete heart block in a 10-year-old girl

ABSTRACT

Juvenile dermatomyositis (JDM) is an auto-immune inflammatory condition associated with cardiac disorders including conduction abnormalities and myocardial dysfunction. The time of presentation of cardiac abnormalities can range from disease onset to after long-term follow-up, emphasising the importance of screening for cardiac involvement in JDM. A previously healthy 10-year-old girl presented with syncope, fatigue and weakness associated with a heliotrope rash. JDM was diagnosed based on the clinical, laboratory and imaging findings. An ECG demonstrated complete heart block (CHB). All symptoms resolved following treatment with parenteral corticosteroids. In JDM, it is important to investigate for cardiac manifestations and in CHB to consider administering corticosteroids.

KEYWORDS:

• Juvenile dermatomyositis
• heart block
• MRI
• immunosuppression
• arrhythmia
• myopathy
• cardiac

Additional information

Notes on contributors

Ritwik Ghosh

Dr. Ritwik Ghosh is a second year postgraduate trainee in the Department of General Medicine at Burdwan Medical College and Hospital in Burdwan, West Bengal, India.

Devlina Roy

Dr. Devlina Roy is a third year postgraduate trainee in the Department of General Medicine at Burdwan Medical College and Hospital in Burdwan, West Bengal, India.

Souvik Dubey

Dr. Souvik Dubey is an assistant professor in the Department of Neuromedicine at the Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital in Kolkata, West Bengal, India.

Khaled Abdelrahman

Khaled Abdelrahman is a medical student at the University of Texas at Austin Dell Medical School. He is interested in internal medicine and cardiology and is currently a research fellow at the National Institutes of Health.

Amit Kumar Dey

Dr. Amit Kumar Dey is a research fellow at the National Institutes of health and an incoming resident physician in internal medicine at the Medstar Georgetown University Medical Center.

Subhankar Chatterjee

Dr. Subhankar Chatterjee is a third year postgraduate trainee in the Department of General Medicine at the Rajendra Institute of Medical Sciences in Ranchi, Jharkhand, India.

Durjoy Lahiri

Dr. Durjoy Lahiri is a senior resident working in the Department of Neuromedicine at R.G. Kar Medical College & Hospital in Kolkata, West Bengal, India.

Biman Kanti Ray

Dr. Biman Kanti Ray is a professor in the Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital in Kolkata, West Bengal, India