DOI: 10.12890/2025_005372

Juvenile dermatomyositis and hepatitis B viral infection

Authors

  • Ali A. Younis Department of Medicine, College of Medicine, University of Mosul, Mosul, Iraq; Nineveh Health Directorate, Ibn Sina Teaching Hospital, Mosul, Iraq
  • Ahmed A. Ahmed Al-Harbi Department of Microbiology, College of Medicine, University of Mosul, Mosul, Iraq

ahmabdahmad@uomosul.edu.iq

Keywords

Juvenile dermatomyositis, hepatitis B, Gottron’s papules, heliotrope rash

Abstract

Juvenile dermatomyositis (JDM) is an uncommon autoimmune illness with unexplained origin. It affects the skin, skeletal muscles, and blood vessels.
This case report emphasizes an unusual case of an 8-year-old girl from Ninevah in Iraq, who presented with limb weakness and rash. She had a family history of hepatocellular carcinoma. The patient had hall mark features of JDM: heliotrope rash, Gottron’s papules, and progressive proximal muscle weakness as well as elevated muscle enzymes. A positive hepatitis B surface antigen with high viral load proved concomitant infection. Treatment started with entecavir and intravenous immunoglobulins, followed by methotrexate and corticosteroids leading to steady clinical improvement. Effective antiviral treatment in combination with immunosuppressants is crucial for treating autoimmune diseases without infection reactivation.
The correlation between hepatitis B infection and JDM is still obscure. This case suggests that that hepatitis B may lead to autoimmune diseases when there is a genetic susceptibility. This example adds to the scarce literature on JDM connection with viral hepatitis, highlighting the importance of being alert and using specialized treatment approaches in such cases.

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A) Periorbital puffiness and heliotrope rash at presentation; B) Marked improvement of periorbital puffiness and heliotrope rash 4 months after treatment.

Published

2025-04-28

How to Cite

1.
Younis AA, Al-Harbi AAA. Juvenile dermatomyositis and hepatitis B viral infection. EJCRIM [Internet]. 2025 Apr. 28 [cited 2026 Nov. 3];12(5). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5372