Use of intravenous immune globulin in the therapy of children with rheumatological diseases

Abstract

Traditional treatment of dermatomyositis often fails and is associated with severe side effects, especially in children. Similarly, some patients with systemic juvenile rheumatoid arthritis continue to develop crippling arthritis despite the currently used modalities of therapy. We have used monthly infusions of intravenous immune globulin (2 g/kg/month) in patients with dermatomyositis or systemic juvenile rheumatoid arthritis who have not responded to traditional treatment. We show that intravenous immune globulin is beneficial in improving muscle strength and skin manifestations of dermatomyositis. In a similar fashion, intravenous immune globulin infusions were very effective in ameliorating systemic manifestations of systemic juvenile rheumatoid arthritis but less effective in controlling long-lasting arthritis (more than 1 year). We established prognostic criteria early after disease onset which predict the development of severe joint disease and should help in patient selection for future studies.