03 July 2026
: Case report 
Pancreatic Adenocarcinoma Presented as Paraneoplastic Dermatomyositis Complicated with Rhabdomyolysis: Case Report and Review
Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Jafar Alsheyyab ACDEF 1,2*, Hala Ahmad Al-Mahasneh BCEF 3, Shaimaa Y. Al-khalaileh ABCEF 1, Hamzah A. Hasan
BD 1,2, Khitam Al-Refu AEF 3
DOI: 10.12659/AJCR.952839
Am J Case Rep 2026; 27:e952839
Table 1 Laboratory test results and clinical course of the present case.
| Day | CK (U/L) | Creatinine (μmol/L) | AST (U/L) | ALT (U/L) | Clinical notes |
|---|---|---|---|---|---|
| Day 1 | 4267 | 125 | 368 | 122 | Fatigue, myalgia, initial rhabdomyolysis |
| Day 2 | 8000 | 221 | 420 | 130 | Acute kidney injury, hyperkalemia; hemodialysis started |
| Day 3 | 25 229 | 240 | 410 | 128 | Severe muscle pain, rhabdomyolysis confirmed |
| Day 6 | 10 500 | 200 | 350 | 110 | Aspiration pneumonia, hypoxia |
| Day 9 | 7800 | 170 | 300 | 95 | Rash and proximal muscle weakness appear |
| Day 13 | 5000 | 160 | 260 | 90 | Dysphagia, positive antinuclear antibody, negative extractable nuclear antigen, suspected dermatomyositis |
| Day 16 | 3200 | 140 | 200 | 80 | Computed tomography shows pancreatic mass; biopsy confirms adenocarcinoma |
| Day 22 | 1200 | 120 | 150 | 70 | After IV methylprednisolone: marked improvement |
| Day 29 | 600 | 110 | 100 | 65 | Transferred for positron emission tomography evaluation; stable condition |
| Abbreviations: CK, creatine kinase; AST, aspartate aminotransferase; ALT, alanine aminotransferase. | |||||