Anti-Ro-Positive Dermatomyositis Presenting as a Clinical Mimic of Guillain-Barré Syndrome: A Case Report

Dermatomyositis is a multi-system, connective tissue immune-mediated inflammatory condition characterised by myositis and distinct skin manifestations, with a higher prevalence in women. Symptoms typically appear in adulthood, though a juvenile form exists. Early signs may include Gottron's papules and heliotrope rash, with proximal muscle weakness as the second most common initial symptom. This report discusses a case of a 55-year-old woman whose presentation initially resembled acute demyelinating polyneuropathy (ADP), beginning with an eight-week history of dry cough and a five-day history of diarrhoea for four weeks followed by muscle weakness and no skin signs. The patient, who had delayed medical attention, presented with significant proximal muscle weakness and absent reflexes, resulting in a debilitating reduction in her baseline mobility. Initial investigations that were conducted included an elevated creatinine kinase (CK) level and reduced forced vital capacity (FVC). Her cerebrospinal fluid (CSF) analysis showed elevated proteins. She was admitted to the intensive care unit due to a declining FVC, and receiving intravenous immunoglobulin (IVIG), which resulted in some improvement. Over time, she developed skin manifestations and responded to treatment with mycophenolate mofetil (MMF) and corticosteroids.