Case report
Rare Association of Chronic Lymphocytic Thyroiditis with Dermatomyositis

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Abstract

Autoimmune thyroid disease (AITD) has been associated with other autoimmune diseases such as chronic urticaria, insulin-dependent diabetes mellitus, Sjøgren's syndrome, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, psoriasis, ankylosing spondylitis, and dermatomyositis (DM) 1, 2. AITD is a common disorder affecting primarily women, and both genetic and environmental factors are included in its pathogenesis (3). DM is considered an autoimmune disease of the muscles and skin. Although AITD is the most common cause of hypothyroidism, to the best of our knowledge, only three cases of DM and AITD in the same patient have been reported in the last 40 years 4, 5, 6. We consider that both are developed from the same autoimmune background. Herein, we present a case of a 30-year-old man with a 4-year history of AITD who was diagnosed as suffering as well from DM.

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Case Report

A 30-year-old man was admitted to the hospital complaining of musculoskeletal pain in his proximal limb muscles, especially of the legs and thighs, weakness, and fever 38°C. He mentioned occasional constipation, loss of appetite and dry skin. Physical examination revealed a diffuse swelling of the left lobe of the thyroid gland which was very firm, an edematous erythema in face, neck, chest and extremities as well as fever 38°C. Muscle strength of the extremities was grade 2. The fine needle

Discussion

DM is a disease of presumed autoimmune etiology in which skin and skeletal muscles are damaged by a nonsuppurative inflammatory process dominated by lymphocytic infiltration 2, 7. In about 8.5% of the patients, there appears an underlying malignancy, especially in those >40 years of age. (8). This malignancy may precede or follow the onset of myositis by up to 2 years (8). The most common malignancies are lung, pancreatic, stomach, colorectal, ovarian and breast cancer as well as

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