1542 - When Rehab Meets Resilience: A Case of Remarkable Recovery in Fulminant Dermatomyositis

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

NM

Nimesha Mehta, DO

Resident Physician
Montefiore Medical Center
Morganville, New Jersey, United States

Co-Author(s)

TH

Tyler Hwang, BS

Medical Student
Georgetown University School of Medicine
Bethesda, Maryland, United States
JS

Jordan Schnoll, MD

Resident Physician
Albert Einstein College of Medicine/Montefiore
New York, New York, United States
GG

Giorgina Giampaolo, MD

Resident Physician
Montefiore Medical Center
Bronx, New York, United States
MS

Michelle Stern, MD

Attending Physician
Jacobi Medical Center
Bronx, New York, United States

Submitter(s)

NM

Nimesha Mehta, DO

Montefiore Medical Center
Morganville, New Jersey, United States

Case Diagnosis: Fulminant dermatomyositis is a rapid and life-threatening autoimmune condition. It is rare, but significant for inflammation that affects skeletal muscle. It can cause multiorgan failure including in the lungs and kidneys, and can be diagnosed through skin or muscle biopsy.

Case Description: A 34-year-old male with no prior medical history was diagnosed with fulminant dermatomyositis following progressive ascending weakness and impending respiratory failure requiring tracheostomy with subsequent decannulation and PEG placement. Diagnosis was confirmed by skin biopsy and the patient was treated with azathioprine, IVIG, and IV Rituximab. On admission to acute rehabilitation, he exhibited profound generalized weakness, with near complete loss of strength in the upper extremities and significant weakness in the proximal lower limb. He required maximal assistance for bed mobility and transfers. The patient was discharged and re-admitted to acute rehab multiple times due to complications including hematemesis, pneumoperitoneum, and a persistent intraabdominal abscess.

Discussions: Fulminant dermatomyositis is an inflammatory myopathy with a poor prognosis due to rapid progression leading to profound weakness. This case highlights the role of rehabilitation in improving both strength and mobility after this critical course of illness. With intensive therapy, the patient had almost full recovery of motor strength in his upper and lower extremities. He advanced to a regular diet, ambulated 180 feet at supervision level with a rolling walker, and became independent in bed mobility and transfers, despite multiple medical complications. The patient was able to safely return home to his family.

Conclusions: This case demonstrates the devastating complications of a rare diagnosis such as fulminant dermatomyositis in a young, previously independent male. Intensive, structured, multidisciplinary rehabilitation, along with appropriate immunosuppressive therapy can provide significant functional recovery even in patients with severe neuromuscular weakness and provide meaningful improvement in their quality of life.