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. 1985 Mar;60(3):236–244. doi: 10.1136/adc.60.3.236

Prognosis and treatment of polymyositis with particular reference to steroid resistant patients.

M Yoshioka, T Okuno, H Mikawa
PMCID: PMC1777183  PMID: 3985655

Abstract

Eight boys and six girls with polymyositis examined between 1967 and 1982 were studied. The mean age of disease onset was 5 years 5 months. The initial regimen was prednisolone, 1.2 to 2.3 mg/kg/day, and after four weeks this dose was decreased gradually to a maintenance level of 5 to 20 mg on alternate days. The total treatment period was 3 years 6 months on average. Eleven of the 14 children had a uniphasic course, and steroids were stopped without a resurgence of the disease: three were refractory to steroid treatment. One of these died of a cardiomyopathy seven years after the onset of the illness despite treatment with steroids and cyclophosphamide; the second was treated with adrenocorticotrophic hormone after prednisolone, but without benefit; and in the third a series of treatment with lympho-plasmapheresis and cyclophosphamide resulted in some improvement. As cardiac involvement in polymyositis may become overt if the disease persists for many years, patients refractory to steroids should be given alternative treatment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson L., Ziter F. A. Plasmapheresis via central catheter in dermatomyositis: a new method for selected pediatric patients. J Pediatr. 1981 Feb;98(2):240–241. doi: 10.1016/s0022-3476(81)80645-2. [DOI] [PubMed] [Google Scholar]
  2. Brewer E. J., Jr, Giannini E. H., Rossen R. D., Patten B., Barkley E. Plasma exchange therapy of a childhood onset dermatomyositis patient. Arthritis Rheum. 1980 Apr;23(4):509–513. doi: 10.1002/art.1780230415. [DOI] [PubMed] [Google Scholar]
  3. Currie S., Walton J. N. Immunosuppressive therapy in polymyositis. J Neurol Neurosurg Psychiatry. 1971 Aug;34(4):447–452. doi: 10.1136/jnnp.34.4.447. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dau P. C., Bennington J. L. Plasmapheresis in childhood dermatomyositis. J Pediatr. 1981 Feb;98(2):237–240. doi: 10.1016/s0022-3476(81)80644-0. [DOI] [PubMed] [Google Scholar]
  5. Dau P. C. Plasmapheresis in idiopathic inflammatory myopathy. Experience with 35 patients. Arch Neurol. 1981 Sep;38(9):544–552. doi: 10.1001/archneur.1981.00510090038003. [DOI] [PubMed] [Google Scholar]
  6. Dubowitz V. Treatment of dermatomyositis in childhood. Arch Dis Child. 1976 Jul;51(7):494–500. doi: 10.1136/adc.51.7.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hill D. L., Barrows H. S. Identical skeletal and cardiac muscle involvement in a case of fatal polymyositis. Arch Neurol. 1968 Dec;19(6):545–551. doi: 10.1001/archneur.1968.00480060015001. [DOI] [PubMed] [Google Scholar]
  8. Jacobs J. C. Methotrexate and azathioprine treatment of childhood dermatomyositis. Pediatrics. 1977 Feb;59(2):212–218. [PubMed] [Google Scholar]
  9. Lynch P. G. Cardiac involvement in chronic polymyositis. Br Heart J. 1971 May;33(3):416–419. doi: 10.1136/hrt.33.3.416. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Malaviya A. N., Many A., Schwartz R. S. Treatment of dermatomyositis with methotrexate. Lancet. 1968 Aug 31;2(7566):485–488. doi: 10.1016/s0140-6736(68)90649-1. [DOI] [PubMed] [Google Scholar]
  11. Medsger T. A., Jr, Robinson H., Masi A. T. Factors affecting survivorship in polymyositis. A life-table study of 124 patients. Arthritis Rheum. 1971 Mar-Apr;14(2):249–258. doi: 10.1002/art.1780140210. [DOI] [PubMed] [Google Scholar]
  12. Miller G., Heckmatt J. Z., Dubowitz V. Drug treatment of juvenile dermatomyositis. Arch Dis Child. 1983 Jun;58(6):445–450. doi: 10.1136/adc.58.6.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. PEARSON C. M. PATTERNS OF POLYMYOSITIS AND THEIR RESPONSES TO TREATMENT. Ann Intern Med. 1963 Dec;59:827–838. doi: 10.7326/0003-4819-59-6-827. [DOI] [PubMed] [Google Scholar]
  14. Reid J. M., Murdoch R. Polymyositis and complete heart block. Br Heart J. 1979 May;41(5):628–629. doi: 10.1136/hrt.41.5.628. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rose A. L. Childhood polymyositis. A follow-up study with special reference to treatment with corticosteroids. Am J Dis Child. 1974 Apr;127(4):518–522. doi: 10.1001/archpedi.1974.02110230064009. [DOI] [PubMed] [Google Scholar]
  16. Rose A. L., Walton J. N. Polymyositis: a survey of 89 cases with particular reference to treatment and prognosis. Brain. 1966 Dec;89(4):747–768. doi: 10.1093/brain/89.4.747. [DOI] [PubMed] [Google Scholar]
  17. Schaumburg H. H., Nielsen S. L., Yurchak P. M. Heart block in polymyositis. N Engl J Med. 1971 Mar 4;284(9):480–481. doi: 10.1056/NEJM197103042840905. [DOI] [PubMed] [Google Scholar]
  18. Sullivan D. B., Cassidy J. T., Petty R. E., Burt A. Prognosis in childhood dermatomyositis. J Pediatr. 1972 Apr;80(4):555–563. doi: 10.1016/s0022-3476(72)80050-7. [DOI] [PubMed] [Google Scholar]
  19. Whitaker J. N., Engel W. K. Vascular deposits of immunoglobulin and complement in idiopathic inflammatory myopathy. N Engl J Med. 1972 Feb 17;286(7):333–338. doi: 10.1056/NEJM197202172860701. [DOI] [PubMed] [Google Scholar]

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