Abstract

BAUTISTA, WILSON A. et al. INDICATIONS AND UTILITY OF INTRAVENOUS IMMUNOGLOBULIN IN THE TREATMENT OF REFRACTORY POLYMYOSITIS: A CASE REPORT AND LITERATURE REVIEW. rev.fac.med [online]. 2010, vol.18, n.2, pp.241-247. ISSN 0121-5256.

Inflammatory myopathies belong to a heterogeneous group of acquired diseases involving the muscular system. The predominant symptom is weakness associated with muscle soreness. Polymyositis (PM) is a disorder that primarily affects adults and involves proximal muscle structures. Here, a case report of a 19-year-old patient diagnosed with PM is presented as confirmed by clinical evidence (involving proximal muscle, dysphagia), biochemical findings (elevated serum CK), high-resolution optical microscopy, and ultra structure and nuclear magnetic resonance of muscle. The patient was refractory to initial treatment with corticosteroids, azathioprine and cyclophosphamide. With the administration of intravenous immunoglobulin a good clinical response was observed with progressive increase in muscle strength. Although steroids constitute the main treatment, in refractory cases the use of immunosuppressive agents is recommended, base on medical experience or empirical knowledge together with the analysis of safety and efficacy. Intravenous immunoglobulin is widely used in the treatment of various autoimmune diseases and its effectiveness relies on immunomodulatory effect. Controlled clinical studies are needed to evaluate further its efficacy and safety in patients with PM.

Keywords : miopathies; polymyositis; steroids.

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