Myositis - inflammation of muscles, characterized by lesions of the striated and smooth muscle with violation of motor function, as well as skin lesions in the form of redness and edema, especially for open areas body.
The predominant age of the disease: determining the two incidence peaks - at the age of 5-15 and 40-60 years. Predominant floor - a female (2: 1).
The cause of dermatomyositis is not known. The possible role of viral factors, primarily picornavirus. The presence of communication between oncology and dermatomyositis suggests autoimmunity due masking antigenic tumor tissue and muscle tissue.
dermatomyositis treatment
Hormones are the drug of choice in the treatment of dermatomyositis.
- Prednisolone.
In the acute stage of the disease initial dose of prednisolone - 1 mg / kg / day. If no improvement within 4 weeks the dose should be increased to 0.25 mg / kg / month. to 2 mg / kg / day. with adequate assessment of clinical and laboratory efficiency.
After achieving clinical and laboratory remission (but not earlier than after 4-6 weeks of starting treatment) dose of prednisolone gradually reduced (About 1/4 of a daily dose for each month under clinical and laboratory control at a dose of negative dynamics increases again). The total duration of treatment of dermatomyositis - approximately 2-3 years;
- Methotrexate.
When administered an initial dose of 7.5 mg / week. with an increase of 0.25 mg / week. to obtain the effect (less than 25 mg / week.). When administered intravenously, the initial dose of 0.2 mg / kg / week. with an increase of 0.2 mg / kg / week. (Not more than 25 mg / week.) To obtain the effect. In this disease, methotrexate is not introduced into / m!
The clinical effect of the drug usually develops within 6 weeks, the maximum effect - after 5 months. Upon reaching remission methotrexate cancel, gradually reducing the dose (1/4 of a week). In the treatment of dermatomyositis is necessary to conduct general blood tests, urine tests, and liver function tests.
Methotrexate is contraindicated in pregnancy, liver, kidney, bone marrow; incompatible with anticoagulants, salicylates and the drugs, oppressive blood;
- Azathioprine.
Less effective than methotrexate. The dose of 2-3 mg / kg / day. The maximum effect is usually 6-9 months. Further, the daily dose reduced to 0.5 mg / kg every 4-8 weeks until the minimum effective.
Azathioprine is contraindicated in patients with severe bone marrow suppression, severe liver disease, pregnancy;
- Cyclosporin: an initial dose of 2.5-3.5 mg / kg maintenance dose of 2-2.5 mg / kg;
- Cyclophosphamide is used in the development of lung damage by 2 mg / kg / day .;
- Aminohinolinovogo derivatives (. Hydroxychloroquine 200 mg / day) monitor cutaneous manifestations dermatomyositis;
- Immunoglobulin intravenously at a dose of 0.4-0.5 g / kg (treatment duration);
- plasmapheresis, Limfotsitoferez.
