Reversal of Chronic Polymyositis Following Intravenous Immune Serum Globulin Therapy

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Abstract
POLYMYOSITIS is an inflammatory disease of striated muscle, which has been attributed to a vasculopathy. Although the pathogenesis is unknown, studies suggest that an immune mechanism may contribute to this disorder. The evidence consists of the presence of tissue-bound immunoglobulins and complement within blood vessels of involved muscle1 and the in vitro cytotoxic effect of patients' lymphocytes on muscle cells grown in culture.2,3 The mainstay of therapy in polymyositis is corticosteroids. This treatment results in improvement of prognosis and life-style in most patients with this disorder.4-10 However, some individuals are refractory to steroid therapy or demonstrate only a partial response.11,12 In other patients, short- or long-term toxic reactions to corticosteroids force discontinuation of the drug. Such patients who are resistant to or intolerant of corticosteroids have been treated with immunosuppressive agents, including methotrexate sodium,13-17 azathioprine sodium,18-20 cyclophosphamide,17,21,22 and cyclosporine.23 Although patients may

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