title: Childhood dermatomyositis and polymyositis. Treatment with methotrexate and prednisone.
abstract: The conditions of three children with dermatomyositis and one child with polymyositis were treated for nine to 31 months with combined prednisone and intravenous methotrexate (1 mg/kg/wk) when prednisone alone was ineffective in controlling the disease or when there were substantial steroid-related toxic effects. All children showed a major clinical improvement within three months despite concomitant reduction of the prednisone dose. Three children completely recovered; one patient relapsed and died. The toxic effects of methotrexate included elevated liver transaminases (3/4), nausea (2/4), abdominal pain (2/4), bone pain (2/4), mild neutropenia (1/4), and mild pruritus (1/4). Intravenous methotrexate is an effective adjunct to steroid therapy in the treatment of steroid-resistant or life-threatening dermatomyositis-polyositis or dermatomyositis-polymyositis complicated by severe steroid-related effects.
mesh_terms: D002648:Child; D002675:Child, Preschool; D003882:Dermatomyositis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D009220:Myositis / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*
chemical_list: D011241:Prednisone; D008727:Methotrexate