van de Vlekkert J, Hoogendijk J E, Frijns C J M, de Visser M
Academic Medical Centre, Department of Neurology, University of Amsterdam, Amsterdam, The Netherlands.
J Neurol Neurosurg Psychiatry. 2008 Jun;79(6):729-30. doi: 10.1136/jnnp.2007.134676.
Dermatomyositis (DM), polymyositis and unspecified myositis are idiopathic inflammatory myopathies in which prednisone is usually started as soon as the diagnosis has been established. Therefore, little is known about the natural history of these diseases and spontaneous recovery may escape attention. Here, we present three patients who achieved remission without administration of immunosuppressants. In these three patients, treatment was not started because of spontaneously improving symptoms and signs during the diagnostic process. After 3-5 years, all patients are still free of muscle weakness. These case reports demonstrate that spontaneous long lasting remission can occur in a small proportion of patients with subacute onset idiopathic inflammatory myopathies. In some patients, immunosuppressive treatment with the risk of serious side effects can perhaps be omitted. However, close and frequent monitoring is required in these instances.
皮肌炎(DM)、多发性肌炎和未特定的肌炎属于特发性炎性肌病,通常在确诊后即开始使用泼尼松治疗。因此,对于这些疾病的自然病程了解甚少,自发缓解可能未被注意到。在此,我们报告3例未使用免疫抑制剂而病情缓解的患者。在这3例患者中,由于在诊断过程中症状和体征自发改善而未开始治疗。3至5年后,所有患者仍无肌无力症状。这些病例报告表明,一小部分亚急性起病的特发性炎性肌病患者可出现自发的长期缓解。在某些患者中,或许可以省略有严重副作用风险的免疫抑制治疗。然而,在这些情况下需要密切且频繁的监测。