Treatment of inclusion body myositis: is low-dose intravenous immunoglobulin the solution?
Inclusion body myositis (IBM), the most common inflammatory myopathy in the elderly, is often resistant to various forms of therapy. Placebo-controlled treatment trials with high dose intravenous immunoglobulins (IVIG) have shown disease amelioration in some but not all patients. Here, we present the informative case of a 70-year-old woman with diagnosed inclusion body myositis that showed progressive muscle weakness without treatment and following immuno-suppressive treatment with corticosteroids and azathioprine. A trial with low-dose intravenous immunoglobulins was started at that time. The patient responded rapidly to low dose IVIG treatment with amelioration of muscle strength and normalization of CK serum activities. Our results demonstrate that IBM patients may respond to low-dose IVIG treatment which has important clinical and economic consequences.
Recher
Mike
M
Clinic for Immunology, Department of Internal Medicine, University Hospital Zürich, Haeldeliweg 4, 8044 Zurich, Switzerland. mike.recher@usz.ch
Sahrbacher
Ulrike
U
Bremer
Juliane
J
Arndt
Börge
B
Steiner
Urs
U
Fontana
Adriano
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D004351:Drug Resistance / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D018979:Myositis, Inclusion Body / Q000188:drug therapy / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous; D001379:Azathioprine