Dr.Nidhi Paharia Agarwal, N19233
A young male of 18 years presented with sub-acute, painless, progressive diminution of vision in both eyes reduced to FC-CF for last 3 weeks.
On examination violaceous eruption on eyelids along with mild swelling was observed. On fundus examination, splinter haemorrhages of disc, multiple cotton wools spots, intra retinal hemorrhages, purtscher’s like flecken along with pseudo cherry red spot were also seen.
He had severe weakness of lower & upper extremity. Also, dermatologic lesions were also seen on nape of neck, back and flexor aspect of hands.
ESR, LDH, serum CK, serum alkaline phosphatase was found to be elevated.
Diffuse oedema was found in muscles of bilateral gluteal region on MRI. On muscle biopsy, interfasicular and perivascular inflammatory infiltrates were seen.
Conclusion:
Although, purtscter like retinopathy is seen in patients of trauma, acute pancreatitis, connective tissue disorders yet dermatomyositis should be considered as one of the differential diagnosis.
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