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ISSN 2007-6037 (Print)
Órgano Oficial de Difusión de la Asociación Mexicana de Comunicación, Audiología, Otoneurología y Foniatría, A.C.,

2017, Number 1

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Rev Mex AMCAOF 2017; 6 (1)

Dysphagia as a symptom in dermatomyositis. A clinical case

Martin LE, Gómez CA, Valadez JVM

Language: Spanish
References: 12
Page: 11-15
PDF size: 274.77 Kb.


ABSTRACT

Dermatomyositis is an autoimmune myopathy combining skin and striated muscle inflammatory lesions. Dysphagia has been reported in 12 to 54% of those patients with dermatomyositis; it is commonly observed in acute stages of the disease. The suspected diagnosis is clinical and laboratory based. The videofluoroscopic study of swallowing in patients with dysphagia reveals retention of barium in the pyriform sinuses and vallecula, due to an inadequate emptying of the hypopharynx and esophageal dyskinesia. Phoniatric therapy following the acute phase is important to regain muscle tone and function. In this clinical case, we present a 61-year-old female patient who had trouble swallowing. The physical examination revealed mild weakness of the lips, cheeks and tongue, proper muscle tone, slow but preserved movements, decreased gag reflex ++, and decreased sensitivity. The fiberoptic endoscopic evaluation of swallowing showed anterior stroke, stagnation in the vallecula, pyriform sinuses and retropharyngeal region, penetration and aspiration, as well as inefficient clearance by zero laryngeal mobility. Dysarthria with severe oropharyngeal dysphagia and risk of penetration and aspiration, flaccid dysarthria, and velopharyngeal incompetence were diagnosed in our patient.


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