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Successful Treatment of Dermatomyositis During Pregnancy With Intravenous Immunoglobulin Monotherapy

Williams, Lloyd MS1; Chang, Peter Y.1; Park, Ellen1; Gorson, Kenneth C. MD2; Bayer-Zwirello, Lucy MD3

doi: 10.1097/01.AOG.0000253244.45837.7c
Case Reports
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BACKGROUND: 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.

CASE: 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.

CONCLUSION: 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: lucy.bayer-zwirello@cchcs.org.

© 2007 The American College of Obstetricians and Gynecologists