Breems D A, de Haas P W, Visscher F, Sabbe L J, Busch H F, van Doorn P A
Erasmus Universiteit, Faculteit der Geneeskunde en Gezondheidswetenschappen, Rotterdam.
Ned Tijdschr Geneeskd. 1993 Sep 25;137(39):1979-82.
Dermatomyositis is an acquired disease characterised by symmetric predominantly proximal muscle weakness of the arms and legs, and misery. It may be associated with myalgia and there is often a characteristic rash. The mainstay of therapy is corticosteroids. Recently efficacy of intravenous immunoglobulin (IVIg) in chronic refractory dermatomyositis was reported. Because corticosteroids can cause serious side effects, we treated a seven-year-old girl suffering from dermatomyositis with IVIg as initial therapy. After two courses of IVIg infusions at a dose of 0.4 g/kg/day for five consecutive days, the patient made a rapid and complete recovery. This case shows that IVIg may be effective as initial therapy in patients with dermatomyositis. Whether IVIg is really a better treatment than corticosteroids should be investigated in a randomised study.
皮肌炎是一种后天性疾病，其特征为四肢对称性近端肌肉为主的无力以及不适。它可能伴有肌痛，且常出现特征性皮疹。治疗的主要手段是使用皮质类固醇。最近有报道称静脉注射免疫球蛋白（IVIg）对慢性难治性皮肌炎有效。由于皮质类固醇会引起严重的副作用，我们对一名患有皮肌炎的七岁女孩采用IVIg作为初始治疗。以0.4 g/kg/天的剂量连续五天进行两个疗程的IVIg输注后，患者迅速完全康复。该病例表明IVIg可能作为皮肌炎患者的初始治疗有效。IVIg是否真的比皮质类固醇是更好的治疗方法应通过随机研究进行调查。
