A case of dermatomyositis with rhabdomyolysis, rescued by intravenous immunoglobulin

Abstract

We describe a case of severe dermatomyositis (DM) complicated by rhabdomyolysis, acute tubular necrosis, and hemophagocytosis. The case failed to respond to corticosteroids, but showed rapid and significant improvement after the addition of intravenous immunoglobulin (IVIG). While the prognosis of DM is poor when it is complicated by rhabdomyolysis, the early administration of IVIG has the potential to be the cornerstone of its management.

Keywords:

• Dermatomyositis
• Hemophagocytosis
• Rhabdomyolysis
• IVIG

Acknowledgements

We thank Masaki Takayanagi at Ciba Children's Hospital for analyzing CPTII activity, Yosuke Shigematsu at Fukui University for serum acylcarnitine analysis, and Tetsuhiko Yasuno at Fukuoka University for gene analysis.

Conflict of interest

H.K. has served as a consultant to Chugai Pharmaceutical and has received research grants from Eisai Pharmaceutical and Takeda Pharmaceutical. N.M. has received research grants from Abbott, Astellas Pharmaceutical, Banyu Pharmaceutical, Chugai Pharmaceutical, Daiichi Sankyo Pharmaceutical, Eisai Pharmaceutical, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical and Teijin Pharmaceutical. All other authors have declared no conflicts of interest.