Anti-Mi2 Antibody Positive Dermatomyositis with Cardiac involvement in Young African Woman: A Case Report

Dermatomyositis (DM) is a type of idiopathic inflammatory myopathy characterised by the presence of DM-specific antibodies. Cardiac involvement in DM is uncommon. A 35-year-old Senegalese woman presented with muscle weakness, dysphagia, arthralgia and palpitations. Creatine Kinase was elevated at 1291 UI/L, and Anti-Mi2 was positive. Echocardiogram demonstrated tachycardia with subepicardial ischemia. Echocardiography showed slight enlargement of the right ventricle and a moderate reduction in left ventricular ejection fraction at 43 %. Computed Tomography pulmonary angiography was normal. The diagnosis of Anti-Mi2 positive DM with cardiac involvement was made. She was started on Prednisone, Hydroxychloroquine Methotrexate, and cardiac protection drugs (Ramipril and Bisoprolol) which led to an improvement of symptoms and biochemical markers. Cardiac involvement may occur in cases of anti-Mi-2-positive DM, hence the importance of systematic cardiac evaluation to avoid diagnostic delays.