Rheumatology International

, Volume 31, Issue 1, pp 113–115 | Cite as

Intravenous immunoglobulin treatment for pregnancy-associated dermatomyositis

  • Garifallia Linardaki
  • Eleni Cherouvim
  • Georgia Goni
  • Kyriaki A. Boki
Case Report


Pregnancy-associated dermatomyositis (DM) is a rare disorder, until recently treated only with corticosteroids due to the toxicity of other immunosuppressive agents for the fetus. We present a pregnant woman with DM treated successfully with intravenous immunoglobulin (IVIG) and medium dose corticosteroids. A 42-year-old woman presented with a rash, muscle weakness and increased muscle enzymes on the 15th week of her first pregnancy. After the diagnosis of DM she was treated with the combination of medium dose corticosteroids and IVIG. The patients’ symptoms resolved rapidly. No complications were noted for either her or the fetus. Both she and her son remain disease-free after 6 years follow-up. In conclusion, IVIG treatment is a safe and effective alternative for pregnancy-associated DM.


Pregnancy Dermatomyositis Intravenous immunoglobulins 


  1. 1.
    Silva CA, Sultan SM, Isenberg DA (2003) Pregnancy outcome in adult-onset idiopathic inflammatory myopathy. Rheumatology 42:1168–1172CrossRefPubMedGoogle Scholar
  2. 2.
    Chopra S, Suri V, Bagga R, Thami MR, Sharma A, Bambery P (2008) Autoimmune inflammatory myopathy in pregnancy. Medscape J Med 10:17PubMedGoogle Scholar
  3. 3.
    Vancsa A, Ponyi A, Constantin T, Zeher M, Danko K (2007) Pregnancy outcome in idiopathic inflammatory myopathy. Rheumatol Int 27:435–439CrossRefPubMedGoogle Scholar
  4. 4.
    Pipitone N, Salvarani C (2007) Established and new treatments of the idiopathic inflammatory myopathies: dermatomyositis and polymyositis. Clin Exp Rheumatol 25:896–906PubMedGoogle Scholar
  5. 5.
    Levitz M, Jansen V, Dancis J (1978) The transfer and metabolism of corticosteroids in the perfused human placenta. Am J Obstet Gynecol 132:363–366PubMedGoogle Scholar
  6. 6.
    Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407CrossRefPubMedGoogle Scholar
  7. 7.
    Williams L, Chang PY, Park E, Gorson KC, Bayer-Zwirello L (2007) Successful treatment of dermatomyositis during pregnancy with intravenous immunoglobulin monotherapy. Obstet Gynecol 109:561–563CrossRefPubMedGoogle Scholar
  8. 8.
    Sereda D, Werth VP (2006) Improvement in dermatomyositis rash associated with the use of antiestrogen medication. Arch Dermatol 142:70–72CrossRefPubMedGoogle Scholar
  9. 9.
    Nelson JL (1998) Pregnancy immunology and autoimmune disease. J Reprod Med 43:335–340PubMedGoogle Scholar
  10. 10.
    Artlett CM, Ramos R, Jiminez SA, Patterson K, Miller FW, Rider LG (2000) Chimeric cells of maternal origin in juvenile idiopathic inflammatory myopathies. Childhood Myositis Heterogeneity Collaborative Group. Lancet 356:2155–2156CrossRefPubMedGoogle Scholar
  11. 11.
    Avcin T, Canova M, Guilpain P, Guillevin L, Kallenberg CGM, Tincani A et al (2008) Infections, connective tissue diseases and vasculitis. Clin Exp Rheumatol 26(1 Suppl 48):S18–S26PubMedGoogle Scholar
  12. 12.
    Mosca M, Strigini F, Carmignani A, D’ascanio A, Genazzani AR, Bombardieri S (2005) Pregnant patient with dermatomyositis successfully treated with intravenous immunoglobulin therapy. Arthritis Rheum 53:119–121CrossRefPubMedGoogle Scholar
  13. 13.
    Dalakas MC, Illa I, Dambrosia JM, Soueidan SA, Stein DP, Otero C et al (1993) A controlled trial of high dose intravenous immune globulin infusions as treatment for dermatomyositis. N Engl J Med 329:1993–2000CrossRefPubMedGoogle Scholar
  14. 14.
    Dalakas MC, Hohlfeld R (2003) Polymyositis and dermatomyositis. Lancet 362:971–982CrossRefPubMedGoogle Scholar
  15. 15.
    Branch DW, Porter TF, Paidas MJ, Belfort MA, Gonic B (2001) Obstetric uses of intravenous immunoglobulin: successes, failures, and promises. J Allergy Clin Immunol 108(Suppl 4):S133–S138CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Garifallia Linardaki
    • 1
  • Eleni Cherouvim
    • 2
  • Georgia Goni
    • 2
  • Kyriaki A. Boki
    • 2
  1. 1.Internal Medicine RegistrarTzanio HospitalAthensGreece
  2. 2.Rheumatology DepartmentSismanoglio HospitalAthensGreece

Personalised recommendations