Intravenous pulse methylprednisolone treatment of juvenile dermatomyositis

Authors

  • Ronald M. Laxer Mdcm, Frcp (C),

    Corresponding author
    1. Assistant Professor of Pediatrics, University of Toronto, and Assistant, Canadian Arthritis Society
    2. Division of Immunology/Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; the Division of Pediatric Rheumatology, British Columbia's Children's Hospital; and the University of British Columbia, Vancouver, British Columbia, Canada
    • Division of Immunology/Rheumatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
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  • Leonard D. Stein MD,

    1. Assistant Professor of Pediatrics, University of Toronto, and Assistant, Canadian Arthritis Society
    2. Division of Immunology/Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; the Division of Pediatric Rheumatology, British Columbia's Children's Hospital; and the University of British Columbia, Vancouver, British Columbia, Canada
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  • Ross E. Petty MD, Phd, Faap

    1. Head, Division of Pediatric Rheumatology, British Columbia's Children's Hospital, and Professor of Pediatrics, University of British Columbia
    2. Division of Immunology/Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; the Division of Pediatric Rheumatology, British Columbia's Children's Hospital; and the University of British Columbia, Vancouver, British Columbia, Canada
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Abstract

Recent observations that juvenile dermatomyositis (JDMS) may be a heterogenous disorder, in both its clinical course and prognosis, suggest that subgroups of patients with this disease may respond to various modes of therapy. Therefore, current treatment recommendations of daily, long-term oral corticosteroid treatment, with its attendant side effects, may not be necessary for all children with JDMS. We report the results of treatment with high-dose, pulse intravenous methylprednisolone in 7 children with JDMS, 3 of whom had an excellent response with complete remission and no need for daily steroid therapy. We suggest that patients with early, mild JDMS may be candidates for therapy with intravenous methylprednisolone.

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