Two Cases of Dermatomyositis with Dysphasia Successfully Treated with IVIG

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  • HIROSE Kenji
    Department of Dermatology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • KUBO Yoshiaki
    Department of Dermatology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • NODA Toshinori
    Department of Dermatology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • ARASE Seiji
    Department of Dermatology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • MAKINO Hideki
    Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • ENDO Aki
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • UTSUNOMIYA Masahiro
    Utsunomiya Dermatological and Urological Clinic

Bibliographic Information

Other Title
  • 嚥下障害を伴った皮膚筋炎に対し免疫グロブリン大量療法（ＩＶＩＧ）が奏効した２例
  • 症例 嚥下障害を伴った皮膚筋炎に対し免疫グロブリン大量療法(IVIG)が奏効した2例
  • ショウレイ エンカ ショウガイ オ トモナッタ ヒフ キンエン ニ タイシ メンエキ グロブリン タイリョウ リョウホウ IVIG ガ ソウコウ シタ 2レイ

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Description

Case 1 : 64-year-old man developed erythema on the trunk, upper arm and dorsal skin of the fingers. Although he had no muscle weakness, chest computed tomography revealed interstitial pneumonia. Based on the characteristic dermatitis, dermatomyositis with interstitial pneumonia was diagnosed. Afterwards, dysphasia appeared and swallowing function gradually got worse despite systemic treatment with prednisolone 60 mg/day. Case 2 : 80-year-old man presented with violaceous erythema on the face and hyperkeratotic erythema on the back of all fingers. He also complained of muscle weakness of the extremities and difficulty swallowing. Myopathic changes on electromyography and increased serum aldolase and myoglobin levels were observed. A diagnosis of dermatomyositis with dysphasia was made. Systemic corticosteroid (prednisolone 60 mg/day) improved skin lesions and muscle strength ; however, no improvement was observed in the severe dysphasia. Intravenous immunoglobulin (IVIG) therapy (0. 4 g/kg/day, 5 day continuous-infusion) showed excellent effects on swallowing function of these 2 cases. Dysphasia is one of the factors closely related to poor prognosis in patients with dermatomyositis. Therefore, IVIG therapy is suggested to be a good option for severe dysphasia resistant to corticosteroid or immunosuppressive therapy in dermatomyositis.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 72 (4), 344-348, 2010

    Western Division of Japanese Dermatological Association

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