Dermatomyositis is rare during pregnancy and, if untreated, is associated with poor fetal outcome. Corticosteroids are a standard treatment for dermatomyositis in pregnancy, but they have adverse effects. Intravenous immune globulin is an effective therapy for this condition and may have few adverse effects.
A young, white primigravida presented with dermatomyositis at 4 5/7 weeks of gestation (creatine kinase 2,762 units/L). Intravenous immune globulin was administered monthly at a dose of 1 g/(kg·d) for 2 consecutive days. The patient’s symptoms resolved and no complications were experienced during therapy. At term, creatine kinase was 29 units/L and a healthy 3,657.5-g (8-lb, 1-oz) neonate was born.
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.
A patient with dermatomyositis who was treated with intravenous immunoglobulin monotherapy without therapy-related complications delivered a healthy infant at term.
From the 1Tufts University School of Medicine, Boston, MA; and the Departments of 2Neurology and 3Maternal Fetal Medicine, Caritas St. Elizabeth’s Medical Center, Boston, Massachusetts.
Corresponding author: Lucy Bayer-Zwirello, MD, Tufts University School of Medicine, Caritas St. Elizabeth Medical Center, Dept. of OB-GYN, 736 Cambridge Street, Boston, MA 02135; e-mail: email@example.com.