Anti-transcription Intermediary Factor1γ-antibody-positive Dermatomyositis Complicated by Dysphagia.

A man who was aged in his 80s was hospitalized in our department because of Gottron's sign, muscle weakness and dysphagia. He was diagnosed with dermatomyositis (DM) based on the physical symptoms, muscle enzyme elevation and the results of electromyography. Immunoprecipitation for myositis-specific antibodies revealed bands of 140/155 kDa (Picture 1), which were compatible with anti-transcription intermediary factor-1γ (TIF-1γ)-antibody (1). Although we could not perform colonoscopy because the patient did not undergo pretreatment, no evidence of malignancy was found on computed tomography or esophagogastroduodenoscopy. Videofluoroscopy showed that liquid had entered the lungs and paste and porridge intrusion in the larynx (Picture 2). T2-weighted fat-saturated magnetic resonance imaging revealed an area of high signal intensity in the levator veli palatini muscle and lateral pterygoid (Picture 3), which was improved by prednisolone and tacrolimus. Although dysphagia persisted, even after the start of immunosuppressive treatment, it was gradually improved by rehabilitation. Mugii et al. reported that 10 of 13 patients DM with dysphagia were positive for anti-TIF-1γ-antibodies (2). We presented images of dysphagia related to anti-TIF-1γ-antibody-positive DM. Dysphagia should be noted as an important complication of anti-TIF-1γ-antibody-positive DM.

Picture 1.

Picture 2.

Picture 3.

The authors state that they have no Conflict of Interest (COI).