An interesting case report of polymyositis- presenting as quadriparesis with dysphagia and subcutaneous edema

Abstract

A 15 year old boy was presented with complaints of weakness and swelling of all four limbs, fever, dysphagia and dysarthria for 10 days. Examination showed nonpitting subcutaneous edema of limbs, minimal tenderness in limbs, weakness was more in proximal than distal, lingual plus      guttural dysarthria ,preserved gag reflex.CPK and LDH both were raised 100 fold.ANA weakly positive,anti dsDNA,antiJO,anti U1RNP ,anti CCP were negative.EMG, muscle biopsy and MRI muscle all showed polymyositis         pictures. Patient was started on steroid and responded well within3weeks. We report a rare presentation of polymyositis with dysphagia ,dysarthria and diffuse non pitting                 subcutaneous edema.