Stoll T, Michel B A, Neidhart M, Wassmer P, Neidl K, Fehr K, Wagenhäuser F J
Rheumaklinik und Institut für Physikalische Therapie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1992 Sep 26;122(39):1458-65.
Corticosteroids and immunosuppressive agents are standard treatment for polymyositis (PM) and dermatomyositis (DM) respectively. Recent reports have emphasized a potentially successful regimen with intravenous immune gammaglobulins (IVIG). The short term success of this treatment in a personally observed case is described. IVIG treatment resulted in normalization of the serum concentrations of the muscle enzymes after continued inflammatory activity under treatment with azathioprine, cyclophosphamide and methotrexate in combination with corticosteroids. The improvement of PM by IVIG was further documented by an increase in muscle strength of up to 367% of the initial value and a regression of the myositic changes in the muscles of the thighs as evidenced by magnetic resonance imaging (MRI). The therapeutic response was paralleled by reversal of peripheral lymphopenia. Experience with IVIG treatment in PM/DM is reviewed and the potential role of this regimen in the management of PM/DM is discussed.
皮质类固醇和免疫抑制剂分别是治疗多发性肌炎（PM）和皮肌炎（DM）的标准疗法。最近的报告强调了静脉注射免疫球蛋白（IVIG）可能成功的治疗方案。本文描述了在一个亲自观察的病例中这种治疗的短期成功情况。在用硫唑嘌呤、环磷酰胺和甲氨蝶呤联合皮质类固醇治疗期间炎症持续活动的情况下，IVIG治疗使肌肉酶的血清浓度恢复正常。IVIG对PM的改善进一步体现在肌肉力量增加至初始值的367%，以及磁共振成像（MRI）显示大腿肌肉的肌炎变化消退。外周淋巴细胞减少的逆转与治疗反应平行。本文回顾了IVIG治疗PM/DM的经验，并讨论了该方案在PM/DM管理中的潜在作用。
