Treatment of dermatomyositis with intravenous immunoglobulin

Abstract

A patient affected by dermatomyositis, who did not respond to conventional therapies (steroids alone and in association with immunosuppressive drugs), developed necrotic lesions in the axillary and antecubital folds. The lesions did not improve after increasing the steroid dose. Treatment with intravenous immunoglobulin (IVIG) at a dose of 1 g/kg daily for 2 successive days every 4 weeks was started. Ten days after the first infusion of IVIG the cutaneous lesions disappeared and in the following months the muscle symptoms improved as well. The patient was treated with ten cycles of IVIG and then at a maintenance dose of 1 g/kg over one day every third month. This treatment has been demonstrated to be effective, but it is necessary to underline the need for an accurate selection of patients. The cost of nine months of therapy for a patient of 55 kg in body weight is about ±41 350 (L. 100 000 000).

Key Words:

• Dermatomyositis
• Intravenous immunoglobulin