Intravenous immunoglobulins as treatment of life threatening esophageal involvement in polymyositis and dermatomyositis

Esophageal involvement is considered a major cause of morbidity and an indi cator of poor prognosis in polymyositis (PM) and dermatomyositis (DM). We d escribe 3 patients with steroid resistant PM/DM with life threatening esoph ageal involvement, resulting in impossible oral feeding and enteral nutriti on with a gastric tube. All patients had both dramatic and rapid improvemen t of all clinical manifestations after initiation of intravenous immunoglob ulin (IVIG) therapy. Swallowing disorders completely disappeared after the second infusion of IVIG, which permitted normal oral feeding and ablation o f the gastric tube. Our findings suggest IVIG should be considered the trea tment of choice in such cases.