Methotrexate and cyclosporin are of value in the treatment of adult linear IgA disease

Abstract

We report the case of a 78-year-old woman who presented with adult linear IgA disease (LAD). Control of her disease was difficult due to intolerance of dapsone and the poor response to other sulphone drugs. Immunosuppressive therapy with azathioprine and corticosteroids was ineffective, whereas the combination of methotrexate and low-dose prednisolone led to remission. Methotrexate was discontinued after 18 months due to deteriorating liver function, and the subsequent relapse was controlled with cyclosporin. To our knowledge the use of methotrexate or cyclosporin have not previously been described in LAD but our experience suggests that they are more effective agents than azathioprine.