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Case Reports in Rheumatology
Volume 2015, Article ID 817592, 3 pages
http://dx.doi.org/10.1155/2015/817592
Case Report

Dramatic Improvement of Subcutaneous Calcinosis by Intermittent, High-Dose Etidronate plus Cimetidine in a Patient with Juvenile Dermatomyositis

1Department of Rheumatology, Tokai University Hachioji Hospital, 1838 Ishikawamachi, Hachioji 192-0032, Japan
2Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan

Received 18 June 2015; Revised 2 November 2015; Accepted 2 November 2015

Academic Editor: Jamal Mikdashi

Copyright © 2015 Takayuki Wakabayashi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 17-year-old boy with juvenile dermatomyositis presented with typical skin symptoms, mild myositis, and bilateral lower limb calcinosis. His skin and muscle symptoms responded to treatment with prednisolone and azathioprine. However, calcinosis did not improve, and the patient had a limited range of knee joint motion and resultant disturbance of daily activities. Cimetidine was combined with intermittent administration of high-dose etidronate, leading to marked improvement of both subcutaneous and muscular calcinosis with no skeletal adverse reactions during a long treatment period exceeding 5 years. As a result, the range of knee joint motion has increased and performance of daily activities has improved.