Volume 6 Supplement 1

15thPaediatric Rheumatology European Society (PreS) Congress

Open Access

Gastroparesis associated with Juvenile Dermatomyositis

  • N Martin1,
  • J Davidson1,
  • H Harris2 and
  • P Gillett1
Pediatric Rheumatology20086(Suppl 1):P217

DOI: 10.1186/1546-0096-6-S1-P217

Published: 15 September 2008


Gastrointestinal involvement is well recognised in juvenile dermatomyositis (JDM) Dysphagia due to pharyngeal and upper oesophageal dysmotility occurs in 33% of UK patients [1]. Gastrointestinal vasculitis with ulceration and intestinal perforation is also described. There is only one previous report highlighting gastric dysmotility associated with juvenile dermatomyositis [2].


We present two cases where gastroparesis was associated with JDM and improved with immunosuppression. Clinical features and investigations are summarised in table 1.
Table 1

Clinical features and investigations


Case 1

Case 2


Juvenile dermatomyositis with overlap features

Juvenile dermatomyositis

Age at onset of gastric dysmotility symptoms



Age at diagnosis of connective tissue disorder



Features of dermatomyositis

Rash, proximal weakness, raised muscle enzymes (CK 6926 units/l, ALT 126 units/l)

Rash, muscle pain, raised muscle enzymes (ALT 143 units/l LDH 1097 units); abnormal muscle MRI

Other clinical features


Pulmonary fibrosis


Gastrointestinal features


Abdominal pain

Weight loss

Required NJ feeding

Recurrent vomiting and abdominal pain


ANA, 1/640

RF, Anti Ro, La, Sm, RNP positive

ANA 1/640.

Gastrointestinal investigations

Gastric emptying study grossly delayed

H. Pylori negative

barium normal

Normal endoscopy

Coeliac screen negative

H. Pylori negative



Mycophenolate Mofetil, Intravenous immunoglobulin


Response to treatment

Normal gastric emptying study

Reduced frequency and severity of symptoms


Gastric dysmotility may complicate JDM. In both these cases it presented with intractable vomiting and otherwise normal gastrointestinal investigations. Neither had evidence of otherwise active JDM at the time of onset of their vomiting but both responded to immunosuppression.

Authors’ Affiliations

Royal Hospital for Sick Children
Victoria Hospital


  1. McCann LJ, Juggins AD, Maillard SM, Wedderburn LR, Davidson JE, Murray KJ, Pilkington CA: Juvenile Dermatomyositis Research Group. The Juvenile Dermatomyositis National Registry and Repository (UK and Ireland)–clinical characteristics of children recruited within the first 5 yr. Rheumatology. 2006, 45 (10): 1255-1260. 10.1093/rheumatology/kel099.View ArticlePubMedGoogle Scholar
  2. Laskin BL, Choyke P, Keenan GF, Miller FW, Rider LG: Novel gastrointestinal tract manifestations in juvenile dermatomyositis. Journal of Pediatrics. 1999, 135 (3): 371-374. 10.1016/S0022-3476(99)70137-X.View ArticlePubMedGoogle Scholar


© Martin et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.