Spontaneous pneumomediastinum: an unusual but serious complication of dermatomyositis.

Spontaneous pneumomediastinum is an unusual but severe and potentially fatal complication of dermatomyositis. The authors reported a case of a 60-year-old woman who was referred for investigation of a persistent cough and dyspnoea. On examination she had features diagnostic of dermatomyositis and she was started on prednisolone. A chest X-ray demonstrated bi-basal reticulonodular changes. A High-resolution CT (HRCT) scan of the chest was arranged and when she had this undertaken 4 weeks after her initial review, gross surgical emphysema, extensive pneumomediastinum and small pneumothoraces were seen. She reported no new symptoms and in particular no deterioration in her dyspnoea. She was treated conservatively with a good outcome.