Dermatomyositis: remission induced with combined oral cyclosporine and high-dose intravenous immune globulin

South Med J. 1995 Aug;88(8):866-70. doi: 10.1097/00007611-199508000-00018.

Abstract

Dermatomyositis is an uncommon idiopathic chronic inflammatory disorder. Oral corticosteroids are the treatment of choice. A few patients become resistant to steroids. We describe two patients who, after failure to respond to oral and high-dose intravenous corticosteroids, received a combination of oral cyclosporine and high-dose intravenous immune globulin, with apparent remission. The first patient was a 6-year-old girl with recurrent disease and vasculitis, despite prednisone therapy and normal muscle enzyme levels. The response was remarkable within 3 weeks of therapy. The second patient was a 30-year-old woman with progressive disease and secondary respiratory failure despite oral prednisone and methotrexate therapy. The response to treatment was optimal within 4 weeks. She received maintenance low-dose cyclosporine and a tapering dose of prednisone. The combination of high-dose immune globulin and cyclosporine can be useful and safe in the management of steroid-resistant dermatomyositis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Child
  • Combined Modality Therapy
  • Creatine Kinase / blood
  • Cyclosporine / administration & dosage*
  • Dermatomyositis / drug therapy
  • Dermatomyositis / physiopathology
  • Dermatomyositis / therapy*
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Muscle Contraction
  • Muscle, Skeletal / enzymology
  • Muscle, Skeletal / physiopathology
  • Remission Induction

Substances

  • Immunoglobulins, Intravenous
  • Cyclosporine
  • Creatine Kinase