A 51-year-old woman presents with progressive proximal muscle weakness and difficulty rising from a chair over 3 months. Vital signs show BP 128/82, HR 92, RR 16, temp 37.2°C, SpO2 98%. Examination reveals violaceous discoloration around the eyelids, scaly erythematous papules over the knuckles, and proximal lower extremity weakness (4/5). Serum creatine kinase is elevated at 1,800 U/L. Dysphagia is absent. She takes no immunosuppressive medications. Which of the following is the most likely diagnosis?
- A)Myasthenia gravis
- B)Polymyositis
- C)Inclusion body myositis
- D)ALS
- E)DermatomyositisGABARITO
Explicação
Dermatomyositis causes proximal muscle weakness with characteristic skin manifestations such as a heliotrope rash and Gottron papules. The disease involves complement mediated microangiopathy with perifascicular muscle fiber injury. Ver explicação completa e trilha adaptativa →