Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website

Case Report

Volume 10, Number 9, September 2019, pages 280-283

Significant Muscle Hemorrhage Associated With Low-Molecular-Weight Heparin Use in Dermatomyositis: A Case Report


Figure 1.
Figure 1. (a) Gottron’s papules on both hands. (b) Both periorbital edema and heliotrope rash. (c) Focal wedge-shaped consolidation in right lower lobe and filling defect in the distal right lower pulmonary vein (arrow).
Figure 2.
Figure 2. CT scan of the lower extremities after bleeding. CT scan with contrast shows bleeding into (a) iliopsoas muscle (arrow), and (b) thigh muscle (arrow). CT: computed tomography.


Table 1. Comparison of Six Cases of Dermatomyositis Accompanied by Hemorrhagic Myositis With Heparin Use
CaseAgeSexBleeding sitesType of anticoagulantOnset after administration of anticoagulantCoagulabilityTreatmentOutcomeReference
M: male; F: female; UFH: unfractionated heparin; APTT: activated partial thromboplastin time.
180MLeft rectus sheath, oblique, right thighUFH9 daysAPTT prolongedTransfusionAlive[3]
277FLeft iliopsoas, left iliacus, retroperitoneumUFH, ticlopidine4 daysAPTT prolongedEmbolizationDeath[4]
364FRight psoas, right iliacus, retroperitoneum, left rectus sheathDalteparin9 daysNormalEmbolizationDeath[5]
465FBoth iliopsoases, thighsUFH4 daysAPTT prolongedTransfusionAlive[6]
560MLeft deltoid, left trapeziusUFH6 daysAPTT prolongedTransfusionDeath[7]
643MLeft iliopsoas, left iliacus, retroperitoneumEnoxaparin10 daysNormalTransfusionAliveOur case