Improvement of Satoyoshi syndrome with tacrolimus and corticosteroids.

Abstract

Satoyoshi syndrome (SS) is characterized by progressive, painful intermittent generalized muscle spasms, alopecia, diarrhea, secondary skeletal abnormalities, and endocrinopathy with amenorrhea.1 Corticosteroid treatment2,3⇓ and IV immunoglobulin (IVIg)4 have improved symptoms. We here report that daily tacrolimus with alternate-day oral prednisolone improved amenorrhea and alopecia as well as generalized muscle spasms. A 13-year-old Japanese girl presented with generalized intermittent painful muscle spasms. At age 12, painful 1- to 3-minute muscle spasms, induced easily by voluntary muscle contraction, developed in all extremities. At age 13 she developed alopecia and amenorrhea. The patient had a history of bronchial asthma, atopic dermatitis, and duodenal ulcer but no diarrhea. Family history was unremarkable. On examination, the patient was of normal height (154 cm) and weight (41 kg). Her scalp hair was thin, and her eyebrows, axillary, and pubic hairs were scant. Her mental state, speech, and muscle strength were normal. Deep …