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May 1995

Phosphorus 31 Magnetic Resonance Spectroscopy for Quantitative Evaluation of Therapeutic Regimens in Dermatomyositis

Author Affiliations

Vanderbilt University (Drs King, Park, Adams, and Olsen) and Bureau of Veterans Affairs Medical Center (Dr King), Nashville, Tenn

Arch Dermatol. 1995;131(5):522-524. doi:10.1001/archderm.1995.01690170022003

REPORT OF CASE  A 35-year-old woman (patient 2 in reference 1) was referred to Vanderbilt University Medical Center, Nashville, Tenn, in February 1991 with a 6-month history of a progressive skin eruption, including malar erythema without a heliotrope eruption, Gottron's papules, and poikiloderma on her trunk and arms. She also complained of increasingly severe proximal muscle weakness. An electromyogram indicated myositis, and a muscle biopsy specimen showed changes consistent with polymyositis. Laboratory evaluation of serum muscle enzyme levels, eg, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and aldolase, showed values within the normal range. Additionally, laboratory tests showed the fluorescent antinuclear antibody titer to be 1:320, with a speckled pattern, and negative antibody titers for double-stranded DNA, ribonuclear protein, Smith antigen, SS-A, SS-B, and Jo-l.The patient's clinical course was therapeutically managed over the next 35 months with varying dosages of prednisone, methotrexate, azathioprine, and hydroxychloroquine. The first 5 months of

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