Abstract
Background
Dermatomyositis (DM) is characterized by inflammatory myopathy and distinct skin manifestations. It comprises a diverse clinical spectrum often associated with specific autoantibodies. Notably, the presence of anti-transcriptional intermediary factor 1-gamma (TIF-1γ) antibodies in association with DM is typically seen in older patients and is linked to malignancy in about 15% to 40% of the cases.
Case Presentation
A 24-year-old female with proximal weakness, periorbital edema, heliotrope rash, erosions on oral mucosa, and painful scaly rash on bilateral lower extremities presented after a syncopal episode and fall. Myomarker panel was positive for TIF-1γ antibodies. Imaging and biopsy confirmed findings consistent with inflammatory myopathy. Treatment with steroid pulse therapy and intravenous immunoglobulin led to symptomatic improvement in muscle strength and resolution of the rash. Due to positive TIF-1γ antibody results, the patient underwent evaluation for solid organ malignancy, yielding unremarkable results.
Conclusion
This case highlights a unique case of a young female who was diagnosed with anti-TIF-1γ Ab positive DM, deviating from the typical age pattern associated with this condition. Our goal in presenting this case is to reinforce the importance of recognizing and managing anti-TIF-1γ Ab positive DM, even in atypical demographics. Moreover, the association with malignancy necessitates a comprehensive evaluation to exclude underlying neoplasms, emphasizing the importance of multidisciplinary management involving different specialists.