Objective :
@EN Polymyositis(PM0 and dermatomyositis(DM) are inflammatory muscle diseases of dpresumed autoimmune origin. Many interventions including corticosteroids, immunosuppressive drug, and plasmapheresis to treat patients with PM/DM are not always
effective,
and may be associated with certain serious side effects. Intravenous immunoglobulin(IVIG0 has been useful in a number of autoimmune diseases. An attempt was made to evaluate the efficacy IVIG in refractory PM/DM.
@ES Methods :
@EN Six patients with conventional treatment-refractory PM/DM [1 man and 5 women; mean age of 27(7-49) years ; PM(2), DM(2), juvenile DM(2)] received high doses of IVIG(2 mg/kg) dividing 9over conscutive 2 or 5 days. The IVIG infusion was
conductded
each month for 6 months. Clinical evaluations, ineluding proximal muscle power, functional grading, and biochemical studies(creatine kinase(CK), aldolase) were performed before each or every IVIG infusion. Clinical evaluations were considered
successful
if more than 20% imoprovement of initial score was obtained. Biochemical results were considered ″good″if muscle enzymes decreased more than 30% of initial values.
@ES Results :
@EN Clinical improvement of proximal muscle power was noted in 5 patients after 6 courses of IVIG infusion. Timed stand test and functional grading score wer ealso improved in all patients. All patients showed good response of biochemical
results,
except two cases with normal initial CK levels. Mean daily prednisolone dosage was significantly reduced(before IVIG: 39.2±9.2 mg/day vs after 6th IVIG: 7.3±2 mg/day, p<0.01). One patient experienced mild dyspnea and sweating during the course
of
IVIG
infusion, which were dsappeared with the revduction of daily IVIG dosage.
@ES Conclusion :
@EN These results suggest that IVIG is a safe and effective therapy in patients with PM/DM, who are resistant to traditional therapies or have limitations for their use.
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