DERMATOMYOSITIS - REMISSION INDUCED WITH COMBINED ORAL CYCLOSPORINE AND HIGH-DOSE INTRAVENOUS IMMUNE GLOBULIN

Dermatomyositis is an uncommon idiopathic chronic inflammatory disorde r. Oral corticosteroids are the treatment of choice. A few patients be come resistant to steroids. We describe two patients who, after failur e to respond to oral and high-dose intravenous corticosteroids, receiv ed a combination of oral cyclosporine and high-dose intravenous immune globulin, with apparent remission. The first patient was a 6-year-old girl with recurrent disease and vasculitis, despite prednisone therap y and normal muscle enzyme levels. The response was remarkable within 3 weeks of therapy. The second patient was a 30-year-old woman with pr ogressive disease and secondary respiratory failure despite oral predn isone and methotrexate therapy. The response to treatment was optimal within 4 weeks. She received maintenance low-dose cyclosporine and a t apering dose of prednisone. The combination of high-dose immune globul in and cyclosporine can be useful and safe in the management of steroi d-resistant dermatomyositis.