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High dose intravenous immunoglobulin (IVIG) in dermatomyositis: clinical responses and effect on sIL-2R levels.

Abstract
An open study was conducted to identify and investigate dermatomyositis patients who benefit from IVIG treatment, based on dermatological criteria, myositis-related symptoms and immune/inflammatory parameters. 19 patients (16 females and three males, ages 31-84) suffered from dermatomyositis, and 4/19 patients had paraneoplastic dermatomyositis. We monitored the disease activity by documenting the clinical symptoms, recording muscle-related parameters (electromyography, serum creatine kinase, histopathology), and by determining circulating autoantibodies and serum levels of IL-6, sIL-2R, sTNF-a-R, sICAM-1, and sCD8. 7/19 patients responded to IVIG. They had severe skin but only moderate muscle involvement, no autoantibodies, and no malignancy. IVIG-nonresponders had severe skin and muscle disease, concomitant with autoantibodies and/or malignancy. sIL-2R levels were initially elevated in all patients but reverted to normal in IVIG-responders only. Creatine kinase-levels and other parameters did not correlate with disease activity and/or treatment response. IVIG is effective in selected dermatomyositis patients. sIL-2R serum levels appear to be useful predictors of IVIG-induced treatment response and disease activity.
AuthorsI Göttfried, A Seeber, B Anegg, A Rieger, G Stingl, B Volc-Platzer
JournalEuropean journal of dermatology : EJD (Eur J Dermatol) 2000 Jan-Feb Vol. 10 Issue 1 Pg. 29-35 ISSN: 1167-1122 [Print] France
PMID10694294 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Autoantibodies
  • CD8 Antigens
  • Immunoglobulins, Intravenous
  • Interleukin-6
  • Receptors, Interleukin-2
  • Receptors, Tumor Necrosis Factor
  • Intercellular Adhesion Molecule-1
  • Creatine Kinase
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies (blood)
  • CD8 Antigens (blood)
  • Creatine Kinase (blood)
  • Dermatomyositis (blood, drug therapy, physiopathology)
  • Electromyography
  • Female
  • Humans
  • Immunoglobulins, Intravenous (administration & dosage, therapeutic use)
  • Intercellular Adhesion Molecule-1 (blood)
  • Interleukin-6 (blood)
  • Male
  • Middle Aged
  • Paraneoplastic Syndromes (blood, drug therapy, physiopathology)
  • Receptors, Interleukin-2 (blood)
  • Receptors, Tumor Necrosis Factor (blood)

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