Drop head syndrome as a rare complication in mixed connective tissue disease

Midori Akagi, Masataka Umeda, Mikiko Hashisako, Kazusato Hara, Sousuke Tsuji, Yushiro Endo, Ayuko Takatani, Toshimasa Shimizu, Shoichi Fukui, Tomohiro Koga, Shin Ya Kawashiri, Naoki Iwamoto, Takashi Igawa, Kunihiro Ichinose, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Daisuke Niino, Atsushi Kawakami

Research output: Contribution to journalArticlepeer-review


A 54-year-old woman developed drop head syndrome (DHS), Raynaud's phenomenon and creatine kinase (CK) elevation. She did not meet the international classification criteria of dermatomyositis/polymyositis, as we observed no muscle weakness, grasping pain or electromyography abnormality in her limbs, and antiaminoacyl tRNA synthetase (ARS) antibody was negative. Cervical magnetic resonance imaging and a muscle biopsy of the trapezius muscle revealed myositis findings as the only clinical observations in muscle. These findings, along with her anti-U1-ribonucleoprotein (RNP) antibody positivity and leukopenia, resulted in a diagnosis of mixed connective tissue disease (MCTD). Prednisolone treatment significantly improved her myositis. To our knowledge, this is the first report of DHS as the only muscle complication of MCTD.

Original languageEnglish
Pages (from-to)729-732
Number of pages4
JournalInternal Medicine
Issue number5
Publication statusPublished - Mar 1 2020

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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