Successful Treatment of Dermatomyositis During Pregnancy With Intravenous Immunoglobulin Monotherapy

Williams, Lloyd; Chang, Peter Y.; Park, Ellen; Gorson, Kenneth C.; Bayer-Zwirello, Lucy A.

doi:10.1097/01.aog.0000253244.45837.7c

Cited by 29 publications

(16 citation statements)

References 8 publications

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“…80 A number of Class IV studies have confirmed the effectiveness of IVIG as adjunctive therapy to steroids in treating dermatomyositis. [81][82][83][84][85][86] However, the results from at least one study imply that IVIG may not be effective as a sole therapy for either polymyositis or dermatomyositis. 87 Since dermatomyositis tends to be steroid-responsive, IVIG therapy is generally recommended as add-on treatment in refractory cases.…”

Section: Inflammatory Myopathiesmentioning

confidence: 99%

Consensus statement: The use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the aanem AD HOC committee

et al. 2009

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Intravenous immunoglobulin (IVIG) is a therapeutic biologic agent that has been prescribed for over two decades to treat various neuromuscular conditions. Most of the treatments are given off-label, as little evidence from large randomized trials exists to support its use. Recently, IGIV-C has received an indication for the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). Because of the lack of evidence, an ad hoc committee of the AANEM was convened to draft a consensus statement on the rational use of IVIG for neuromuscular disorders. Recommendations were categorized as Class I-IV based on the strength of the medical literature. Class I evidence exists to support the prescription of IVIG to treat patients with Guillain-Barré syndrome (GBS), CIDP, multifocal motor neuropathy, refractory exacerbations of myasthenia gravis, Lambert-Eaton syndrome, dermatomyositis, and stiff person syndrome. Treatment of Fisher syndrome, polymyositis, and certain presumed autoimmune neuromuscular disorders is supported only by Class IV studies, whereas there is no convincing data to substantiate the treatment of inclusion body myopathy (IBM), idiopathic neuropathies, brachial plexopathy, or diabetic amyotrophy using IVIG. Treatment with IVIG must be administered in the context of its known adverse effects. There is little evidence to advise the clinician on the proper dosing of IVIG and duration of therapy.

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Section: Inflammatory Myopathiesmentioning

confidence: 99%

Consensus statement: The use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the aanem AD HOC committee

et al. 2009

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“…One of these patients had an elective abortion and responded to IVIG after the termination of pregnancy (TOP) [ 30 ]. Two other cases were reported in 2005 [ 31 ] and 2007 [ 32 ]; each patient was treated with IVIG, although the case presented in Mosca et al [ 31 ] was also treated with high doses of corticosteroid. Each mother delivered a healthy baby: the patient treated with steroids had a Cesarean section at 35 weeks, the other had a spontaneous vaginal delivery at term.…”

Section: Pregnancy Outcomes In Which Disease Flares During Pregnancymentioning

confidence: 99%

“…In a second report [ 31 ], the patient was treated with 1 g/kg/day for two consecutive days starting at 17 weeks and continued monthly: the baby was born healthy by Cesarean section at 34 weeks after premature rupture of membranes. In the third report [ 32 ], the patient was treated with 1 g/kg/day for two consecutive days monthly for 3 months starting in the fi rst trimester and remission was achieved by 19 weeks. However, the patient fl ared again at 28 weeks and IVIG was resumed until a spontaneous vaginal delivery at term of a healthy baby.…”

Section: Treatment Optionsmentioning

confidence: 99%

Myositis and Pregnancy

Martino

2014

Contraception and Pregnancy in Patients With Rheumatic Disease

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“…In 2007, Williams et al 26 described a case of a young first time pregnant woman where DM appeared in the first weeks of pregnancy. The administration of intravenous immunoglobulin (1 g/kg month body weight for two consecutive days) was accompanied by a decline of symptoms in conjunction with the reduction of CPK levels.…”

Section: Treatment During Gestationmentioning

confidence: 99%

Patients With Dermatomyositis/Polymyositis During Pregnancy

Zacharias¹,

Nikolaos²,

Emmanuel³

2017

Gynecol Obstet Res Open J

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Dermatomyositis (DM) and polymyositis (PM) belong to the group of inflammatory muscle diseases characterized by inflammation of the muscles. These diseases are usually studied together as dermatomyositis/polymyositis (DM/PM). Regarding pregnant patients affected with DM/PM, important individual issues arise as: (1) Do female patients with DM/PM successfully complete pregnancy, giving birth to healthy infants or is there high risk of complications for both mother and fetus? (2) Is there a connection between activity of DM/PM and high risk of complications during gestation? (3) Does pregnancy increase the risk of DM/PM activation? (4) Does pregnancy increase the risk of DM/PM relapse during or right after gestation? After our attempt to answer these questions, we will refer to the treatment of the disease during pregnancy and the effect it could have on the completion of pregnancy.

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Successful Treatment of Dermatomyositis During Pregnancy With Intravenous Immunoglobulin Monotherapy

Abstract: Pregnant patients with dermatomyositis can be treated with intravenous immune globulin, resulting in good fetal outcome, thus avoiding the deleterious effects of corticosteroid therapy on pregnancy.

Cited by 29 publications

References 8 publications

Consensus statement: The use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the aanem AD HOC committee

Consensus statement: The use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the aanem AD HOC committee

Myositis and Pregnancy

Patients With Dermatomyositis/Polymyositis During Pregnancy

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