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Case Reports
. 2022 Jun 13:9:917050.
doi: 10.3389/fmed.2022.917050. eCollection 2022.

Myocardial Damage in a Highly Suspected Case With Paraneoplastic Pemphigus: A Case Report and Literature Review

Xiao Du  1   2   3   4 , Miao Zhang  1   2   3   4 , Shilan Zhang  1   2   3   4 , Feng Tian  1   2   3   4 , Tie Wen  5   6 , Ling Liu  1   2   3   4
Affiliations
Case Reports

Myocardial Damage in a Highly Suspected Case With Paraneoplastic Pemphigus: A Case Report and Literature Review

Xiao Du et al. Front Med (Lausanne). .

Abstract

Paraneoplastic pemphigus (PNP) is a rare mucocutaneous autoimmune disease. It has multiple clinical accompanied symptoms by affecting various types of epithelia, including the gastrointestinal and respiratory tract. However, an extensive review of the literature found no cases of PNP associated with myocardial damage. Here, we present a 56-year-old male patient with clinically and histopathologically typical paraneoplastic pemphigus (PNP), who had sustained myocardial injury due to non-cardiac disease involvement. Therefore, we suppose that, when persistent cardiac necrosis markers are elevated in patients with paraneoplastic pemphigus (PNP), the possibility of concomitant myocardial damage should get more attention from clinicians to obtain quick diagnosis and treatment.

Keywords: autoantibodies; autoimmune disease; myocardial damage; paraneoplastic pemphigus; tumor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Peri-oral lesions. Palatal and buccal mucosal ulcers and maculopapular lesions, lip crusts. (B–D) Scales on nipple, ulceration of genital, and nail lesions on fingers and toes.
Figure 2
Figure 2
(A) Electrocardiogram for the first (emergency department). Sinus tachycardia, mild depression of the ST segment in V3~V5, T wave inversion in lead V1, and bidirectional in lead V4. (B) Electrocardiogram for the second time (the ward of the department of cardiovascular disease).
Figure 3
Figure 3
Chest radiography. The cardio-thoracic proportion of 0.47, elevating dexter diaphragm.
Figure 4
Figure 4
(A,B) Computed tomography (CT) scan of the thorax and abdomen. A well-defined tumor between the spleen and stomach, measuring 117 × 108 × 91 mm, accompanied by an abundant blood supply and enlarged retroperitoneal lymph nodes. (C,D) The histopathological evaluation of the skin lesions. Suprabasilaracantholysis, keratinocyte necrosis, basal layer damage, and inflammatory cell infiltration in the superficial dermis, including lymphocytes and plasma cells.
See this image and copyright information in PMC

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References

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