Dermatomyositis with massive ascites

There have been few reports of dermatomyositis causing ascites. Here we report a case of a 63-year-old man complaining of general fatigue and gastromegaly. Abdominal examination revealed distension without tenderness. Serum myogenic enzyme was elevated. Electromyographic investigation indicated low amplitude signs, which were compatible with muscle disorder. Abdominal paracentesis on the fifth day yielded 2,500 ml clear, serous fluid. The specific gravity was 1.026 (range 1.005-1.015), with a positive Rivalta reaction, 3.4 g/dl total protein, and 1.59 g/dl albumin, suggesting exudate. Excluding the other causes of exudative ascites, we considered that the ascites was caused by dermatomyositis.