A 6-year-old girl is evaluated for progressive fatigue, diff…
A 6-year-old girl is evaluated for progressive fatigue, difficulty climbing stairs, and inability to rise from the floor without using her hands to “walk” up her legs. Her parents report a recent febrile illness followed by a red rash across the cheeks and a violet discoloration of the eyelids. Laboratory studies reveal elevated creatine kinase and aldolase, and nailfold capillaroscopy shows decreased capillary density. The provider suspects juvenile dermatomyositis (JDM).Which pathophysiologic mechanism most accurately explains the systemic manifestations observed in this condition?