Childhood Dermatomyositis and Polymyositis. Treatment With Methotrexate and Prednisone

Am J Dis Child. 1979 Apr;133(4):386-9. doi: 10.1001/archpedi.1979.02130040040009.

Abstract

The conditions of three children with dermatomyositis and one child with polymyositis were treated for nine to 31 months with combined prednisone and intravenous methotrexate (1 mg/kg/wk) when prednisone alone was ineffective in controlling the disease or when there were substantial steroid-related toxic effects. All children showed a major clinical improvement within three months despite concomitant reduction of the prednisone dose. Three children completely recovered; one patient relapsed and died. The toxic effects of methotrexate included elevated liver transaminases (3/4), nausea (2/4), abdominal pain (2/4), bone pain (2/4), mild neutropenia (1/4), and mild pruritus (1/4). Intravenous methotrexate is an effective adjunct to steroid therapy in the treatment of steroid-resistant or life-threatening dermatomyositis-polyositis or dermatomyositis-polymyositis complicated by severe steroid-related effects.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Child, Preschool
  • Dermatomyositis / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Methotrexate / adverse effects
  • Methotrexate / therapeutic use*
  • Myositis / drug therapy*
  • Prednisone / therapeutic use*

Substances

  • Prednisone
  • Methotrexate