Thursday, June 16, 2011

Juvenile dermatomyositis (DMJ) - Treatment

Therapy of choice in patients diagnosed with dermatomyositis is the nature of the product. Recourse to corticosteroids, prednisone is administered at a dose of 1-2 mg / kg / day or 60 mg/m2/day. Its effect is suppression of inflammation in muscle, decrease pain and muscle weakness occurs in a period of 1-2 weeks. Then reduce the initial dose of prednisone, gradually being possible rebound's appearance, deterioration of muscle function and increased serum enzymes.Reduction in disease remission momemtul corticosteroid dosage is discovered by urinary creatinine, it is the most sensitive test.
Lowering the dose of prednisone is exploratory, aimed at identifying the lowest dose to ensure remission and can be administered SOFT period of time, 1-2 years, the dose was estimated at 5 to 15 mg / day.
It is generally recommended and pulse therapy as with other auto-immune diseases.This consisted of methylprednisolone by intra-venous, at a dose of 30 mg / kg / day for 3 successive days.
Favorable results in improvement of skin lesions are obtained and administered by intra-venous immunoglobulin in high doses in juvenile dermatomyositis cases resistant to corticosteroids, this product has anti-inflammatory effects by modulating production of proinflammatory cytokines.
Dilzem treatment is recommended for a period of 18-24 months in order cessation of developing calcinosis and even regression of tissue calcium deposits.
In severe forms of disease as the only therapeutic efficiency is surgical excision.Muscle lesions respond favorably to therapy with prednisone. If skin lesions are obtained good results METHOTREXATE's administration at a dose of 15-55 mg / week.
Adjuvant treatment consists of physiotherapy. This prevents muscle contractures final installation.Physical therapy is recommended for myalgia. Bed rest is not indicated as favors muscle atrophy.

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