Persistent pneumomediastinum and dermatomyositis: A case report and reviewof the literature

We describe a 42-year-old man with dermatomyositis and interstitial lung di sease who presented with anterior neck pain and dyspnoea. Chest radiographs showed subcutaneous emphysema, pneumomediastinum and diffuse reticulonodul ar infiltration in both lungs. After the administration of high doses of pr ednisolone, an improvement of pulmonary function and respiratory symptoms w as observed but the pneumomediastinum persists 12 months after diagnosis, a nd without any complication. We review the cases that have been reported th us far of pneumomediastinum associated with dermatomyositis and discuss the possible mechanisms involved. We conclude that pneumomediastinum is not an uncommon complication of dermatomyositis and that its aetiopathogenesis re mains very unclear.