Anti-nuclear matrix protein 2 antibody-positive dermatomyositis with gastrointestinal ulcers: A case report

Gastrointestinal manifestations are a very rare complication of dermatomyositis (DM) and are much less frequent in adult cases than in juvenile cases. Only a few previous papers have reported adult patients who had DM with anti-nuclear matrix protein 2 (anti-NXP2) antibodies and who developed gastrointestinal ulcers. Herein, we report a similar case of a 50-year-old man who had DM with anti-NXP2 antibodies followed by relapsing multiple gastrointestinal ulcers. Even after the administration of prednisolone, his muscle weakness and myalgia deteriorated and gastrointestinal ulcers relapsed. In contrast, intravenous immunoglobulin and azathioprine improved his muscle weakness and gastrointestinal ulcers. Based on the parallel disease activity of the muscular and gastrointestinal symptoms, we considered that his gastrointestinal ulcers were a complication of DM with anti-NXP2 antibodies. We also propose that early intensive immunosuppressive therapy would be required for the muscular and gastrointestinal symptoms in DM with anti-NXP2 antibodies.

Automated summary

Gastrointestinal ulcers are a rare complication of dermatomyositis (DM) and occur less frequently in adults compared to juveniles. This case report presents a 50-year-old man with DM and anti-nuclear matrix protein 2 (anti-NXP2) antibodies who experienced relapsing multiple gastrointestinal ulcers. Despite treatment with prednisolone, the patient's muscle weakness and myalgia worsened and the ulcers recurred. However, intravenous immunoglobulin and azathioprine improved both his muscle weakness and gastrointestinal ulcers. The parallel disease activity of the muscular and gastrointestinal symptoms suggest that the ulcers were a complication of DM with anti-NXP2 antibodies. Early intensive immunosuppressive therapy should be considered for the management of muscular and gastrointestinal symptoms in DM with anti-NXP2 antibodies.