Drop head syndrome as a rare complication in mixed connective tissue disease

Midori Akagi; Masataka Umeda; Mikiko Hashisako; Kazusato Hara; Sousuke Tsuji; Yushiro Endo; Ayuko Takatani; Toshimasa Shimizu; Shoichi Fukui; Tomohiro Koga; Shin Ya Kawashiri; Naoki Iwamoto; Takashi Igawa; Kunihiro Ichinose; Mami Tamai; Hideki Nakamura; Tomoki Origuchi; Daisuke Niino; Atsushi Kawakami

doi:10.2169/internalmedicine.3288-19

Drop head syndrome as a rare complication in mixed connective tissue disease

Midori Akagi, Masataka Umeda, Mikiko Hashisako, Kazusato Hara, Sousuke Tsuji, Yushiro Endo, Ayuko Takatani, Toshimasa Shimizu, Shoichi Fukui, Tomohiro Koga, Shin Ya Kawashiri, Naoki Iwamoto, Takashi Igawa, Kunihiro Ichinose, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Daisuke Niino, Atsushi Kawakami

Pathobiology

Research output: Contribution to journal › Article

Abstract

A 54-year-old woman developed drop head syndrome (DHS), Raynaud's phenomenon and creatine kinase (CK) elevation. She did not meet the international classification criteria of dermatomyositis/polymyositis, as we observed no muscle weakness, grasping pain or electromyography abnormality in her limbs, and antiaminoacyl tRNA synthetase (ARS) antibody was negative. Cervical magnetic resonance imaging and a muscle biopsy of the trapezius muscle revealed myositis findings as the only clinical observations in muscle. These findings, along with her anti-U1-ribonucleoprotein (RNP) antibody positivity and leukopenia, resulted in a diagnosis of mixed connective tissue disease (MCTD). Prednisolone treatment significantly improved her myositis. To our knowledge, this is the first report of DHS as the only muscle complication of MCTD.

Original language	English
Pages (from-to)	729-732
Number of pages	4
Journal	Internal Medicine
Volume	59
Issue number	5
DOIs	https://doi.org/10.2169/internalmedicine.3288-19
Publication status	Published - Mar 1 2020

All Science Journal Classification (ASJC) codes

Internal Medicine

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Akagi, M., Umeda, M., Hashisako, M., Hara, K., Tsuji, S., Endo, Y., Takatani, A., Shimizu, T., Fukui, S., Koga, T., Kawashiri, S. Y., Iwamoto, N., Igawa, T., Ichinose, K., Tamai, M., Nakamura, H., Origuchi, T., Niino, D., & Kawakami, A. (2020). Drop head syndrome as a rare complication in mixed connective tissue disease. Internal Medicine, 59(5), 729-732. https://doi.org/10.2169/internalmedicine.3288-19

Drop head syndrome as a rare complication in mixed connective tissue disease. / Akagi, Midori; Umeda, Masataka; Hashisako, Mikiko; Hara, Kazusato; Tsuji, Sousuke; Endo, Yushiro; Takatani, Ayuko; Shimizu, Toshimasa; Fukui, Shoichi; Koga, Tomohiro; Kawashiri, Shin Ya; Iwamoto, Naoki; Igawa, Takashi; Ichinose, Kunihiro; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Niino, Daisuke; Kawakami, Atsushi.

In: Internal Medicine, Vol. 59, No. 5, 01.03.2020, p. 729-732.

Research output: Contribution to journal › Article

Akagi, M, Umeda, M, Hashisako, M, Hara, K, Tsuji, S, Endo, Y, Takatani, A, Shimizu, T, Fukui, S, Koga, T, Kawashiri, SY, Iwamoto, N, Igawa, T, Ichinose, K, Tamai, M, Nakamura, H, Origuchi, T, Niino, D & Kawakami, A 2020, 'Drop head syndrome as a rare complication in mixed connective tissue disease', Internal Medicine, vol. 59, no. 5, pp. 729-732. https://doi.org/10.2169/internalmedicine.3288-19

Akagi, Midori ; Umeda, Masataka ; Hashisako, Mikiko ; Hara, Kazusato ; Tsuji, Sousuke ; Endo, Yushiro ; Takatani, Ayuko ; Shimizu, Toshimasa ; Fukui, Shoichi ; Koga, Tomohiro ; Kawashiri, Shin Ya ; Iwamoto, Naoki ; Igawa, Takashi ; Ichinose, Kunihiro ; Tamai, Mami ; Nakamura, Hideki ; Origuchi, Tomoki ; Niino, Daisuke ; Kawakami, Atsushi. / Drop head syndrome as a rare complication in mixed connective tissue disease. In: Internal Medicine. 2020 ; Vol. 59, No. 5. pp. 729-732.

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abstract = "A 54-year-old woman developed drop head syndrome (DHS), Raynaud's phenomenon and creatine kinase (CK) elevation. She did not meet the international classification criteria of dermatomyositis/polymyositis, as we observed no muscle weakness, grasping pain or electromyography abnormality in her limbs, and antiaminoacyl tRNA synthetase (ARS) antibody was negative. Cervical magnetic resonance imaging and a muscle biopsy of the trapezius muscle revealed myositis findings as the only clinical observations in muscle. These findings, along with her anti-U1-ribonucleoprotein (RNP) antibody positivity and leukopenia, resulted in a diagnosis of mixed connective tissue disease (MCTD). Prednisolone treatment significantly improved her myositis. To our knowledge, this is the first report of DHS as the only muscle complication of MCTD.",

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AU - Iwamoto, Naoki

AU - Igawa, Takashi

AU - Ichinose, Kunihiro

AU - Tamai, Mami

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