Q: My 49 years old mother is suffering from severe pain in her legs and hands. She finds it difficult to move her body. Her weight is 65 kg and height is 154 cm. She has high blood sugar levels and has developed some rashes on her face too. The doctor prescribed Omnokartil when she was not able to get up. She felt somewhat better, but there is no improvement in body pain. In a biopsy test, the symptoms were found related to both dermatomyositis and mitochondrial myopathy. Considering it to be dermatomyositis, the doctor suggested her five steroids daily for five days. Then she was kept under observation for more than 3 months. The second biopsy test reported it as mitochondrial. EMNG was also done, which reported symptoms of dermatomyositis. Now she is taking some protein tablets, but is still suffering from the same severe body pain. However, rashes on the face are gone now. Please suggest.

A:I have gone through the history and treatment of this case. The patient has dermatomyositis which swelling of muscles and skin .She has been treated on correct lines with IV immunoglobulins and steroids. The fact that her skin lesions have improved indicates that she is improving .She needs to be started on steroids and immunosupppresants (steroid sparing drugs). She needs to have serial CPK (muscle enzymes), ESR, monitored.