SEVERE JUVENILE DERMATOMYOSITIS COMPLICATED BY PANCREATITIS

We report two boys with juvenile dermatomyositis (JDM) complicated by pancreatitis. One also had hepatitis and probably mild bowel vasculiti s, while the other had catastrophic bowel vasculitis with multiple per forations. Both were on corticosteroids, but had features of active va sculitis. The former improved with high-dose i.v. pulsed methylprednis olone. while the latter improved only after immunosuppression with i.v . methylprednisolone, cyclophosphamide and plasmapheresis. Although bo wel vasculitis is a known complication of severe JDM, pancreatitis and hepatitis are extremely rare. We have found in a literature search on ly three other reports of pancreatitis complicating JDM. We wish to al ert physicians that pancreatitis may develop in JDM. It should be cons idered as a differential diagnosis in the child with active disease wh o develops abdominal pain. Control of vasculitis with adequate immunos uppression, as well as general supportive measures. may be valuable in the treatment of pancreatitis in JDM.