期刊
JOURNAL OF PEDIATRICS
卷 156, 期 2, 页码 302-307出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2009.09.008
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资金
- NIAMS NIH HHS [K23 AR053202-02, K23 AR053202] Funding Source: Medline
Objective To describe the course of patients with juvenile dermatomyositis (JDM) treated effectively without systemic corticosteroids. Study design A retrospective study of 38 patients with JDM treated at a tertiary care children's hospital identified 8 patients who had never received corticosteroids. Disease presentation and course, pharmacologic, and ancillary treatments were recorded. Results Patients in the no corticosteroid group were followed for a median of 2.8 years (range, 2.1 to 9.5 years). Treatment was primarily with intravenous immunoglobulin (IVIG) (75%) and methotrexate (50%), with favorable response in all. No serious treatment complications were observed; headaches were reported by 3 patients receiving IVIG. Two patients had a myositis flare after discontinuing all medications for more than 1 year; complete resolution of symptoms was observed after either 1 or 2 further doses of IVIG. Two patients had calcinosis ( at 1 and 9 years of disease); however, no patient had joint contractures, muscle atrophy, lipodystrophy, or functional limitations. Conclusions Systemic corticosteroids can be avoided in a select group of patients with JDM. Alternative agents such as methotrexate and IVIG may be prescribed to effectively treat JDM and prevent complications. (J Pediatr 2010; 156: 302-7).
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