Successful treatment with intravenous high-dose immunoglobulin for cardiomyopathy in dermatomyositis complicated with rapid progressive interstitial pneumonia

Yuki Yoshimatsu; Takuya Kotani; Youhei Fujiki; Katsuhiro Oda; Toshiya Kataoka; Kazushi Yamairi; Kenichiro Hata; Kenichiro Otani; Takao Kamimori; Hiroshi Fujiwara

doi:10.1111/1756-185X.12746

Successful treatment with intravenous high-dose immunoglobulin for cardiomyopathy in dermatomyositis complicated with rapid progressive interstitial pneumonia

Int J Rheum Dis. 2019 Feb;22(2):321-324. doi: 10.1111/1756-185X.12746. Epub 2015 Oct 7.

Affiliations

¹ Department of Respiratory Medicine, Yodogawa Christian Hospital, Osaka, Japan.
² Department of Internal Medicine (I), Osaka Medical College, Osaka, Japan.
³ Department of Cardiology, Yodogawa Christian Hospital, Osaka, Japan.
⁴ Department of Rheumatology, Yodogawa Christian Hospital, Osaka, Japan.

PMID: 26443969
DOI: 10.1111/1756-185X.12746

Abstract

Cardiomyopathy and rapid progressive interstitial pneumonia (IP) are potentially fatal complications in polymyositis/dermatomyositis. We experienced a dermatomyositis patient with multiple adverse prognostic factors, complicating rapid progressive IP, macrophage activation syndrome (MAS), and cardiomyopathy. IP and MAS improved with strong immunosuppressive therapy, despite which cardiomyopathy developed. Therefore, we applied intravenous high-dose immunoglobulin therapy (IVIg), and cardiac function improved dramatically. This is the first report to present the effectiveness of IVIg for cardiomyopathy in dermatomyositis.

Keywords: clinical aspects (myositis and related syndromes); drug treatment (myositis and related syndromes); myositis and related syndromes.

Publication types

Case Reports

MeSH terms

Cardiomyopathies / diagnostic imaging
Cardiomyopathies / drug therapy*
Cardiomyopathies / immunology
Cardiomyopathies / physiopathology
Dermatomyositis / diagnosis
Dermatomyositis / drug therapy*
Dermatomyositis / immunology
Disease Progression
Echocardiography
Humans
Immunoglobulins, Intravenous / administration & dosage*
Immunologic Factors / administration & dosage*
Immunosuppressive Agents / administration & dosage*
Lung Diseases, Interstitial / diagnostic imaging
Lung Diseases, Interstitial / drug therapy*
Lung Diseases, Interstitial / immunology
Macrophage Activation Syndrome / diagnosis
Macrophage Activation Syndrome / drug therapy
Macrophage Activation Syndrome / immunology
Male
Middle Aged
Recovery of Function
Tomography, X-Ray Computed
Treatment Outcome
Ventricular Function, Left / drug effects

Substances

Immunoglobulins, Intravenous
Immunologic Factors
Immunosuppressive Agents