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Case Reports in Rheumatology
Volume 2014, Article ID 458231, 4 pages
http://dx.doi.org/10.1155/2014/458231
Case Report

High-Dose Subcutaneous Immunoglobulins for the Treatment of Severe Treatment-Resistant Polymyositis

1Department of Internal Medicine, Pitié-Salpetrière Hospital Group, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
2Octapharma, 92100 Boulogne-Billancourt, France
3Clinique Mutualiste Catalane, 66000 Perpignan, France

Received 14 May 2014; Revised 9 July 2014; Accepted 10 July 2014; Published 16 July 2014

Academic Editor: Masataka Kuwana

Copyright © 2014 Cherin Patrick et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Polymyositis is a rare debilitating condition characterized by chronic inflammation and muscle weakness. Standard treatments include corticosteroids and immunosuppressants; however, resistance to these regimens may develop. Intravenous immunoglobulins (IVIg) are thus recommended for patients with drug-resistant polymyositis. The patient presented a resistant polymyositis with severe muscle weakness, increasing dysphagia, and significant loss in weight. Subcutaneous immunoglobulins (SCIg) were initiated after failure of steroids and immunosuppressive drugs. SCIg was given twice per week (2 then 1.3 g/kg/month). Clinical recovery was observed within 2 months after the SCIg initiation. After several injections, the patient showed a progressive improvement in muscle strength. Serum creatine kinase activity decreased to normal levels, and dysphagia was resolved. The SC injections were generally well tolerated and good patient satisfaction was reported. This promising observation suggests that SCIg may be useful in active and refractory polymyositis.