RESUMO
BACKGROUND AND OBJECTIVE: To analize the response to treatment with oral tacrolimus in severe juvenile dermatomyositis. PATIENTS AND METHOD: Clinical charts of the patients diagnosed at our hospital as having definite juvenile dermatomyositis between 1998 and 2004, who have completed 12 months of treatment with oral tacrolimus, were reviewed retrospectively. The MMT (Manual Muscle Testing)-Kendall scale, the MDAA (Myosits Disease Activity Assessment), and the Riley et al score were used for the evaluation of the muscular and skin response. RESULTS: The study included 6 patients, (evolution: 0.16-11 years). At the end of the follow-up period (12 months) there was a significant improvement at both, muscular and cutaneous level in all patients. Side effects were not observed. Tapering of the daily corticosteroids dose was also possible. CONCLUSIONS: Oral tacrolimus therapy seems to be an effective and safe alternative in cases of severe juvenile dermatomyositis, especially in those with an important cutaneous involvement.
Assuntos
Dermatomiosite/tratamento farmacológico , Imunossupressores/uso terapêutico , Tacrolimo/uso terapêutico , Idade de Início , Criança , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Fundamento y objetivo: Analizar la respuesta al tratamiento con tacrolimus por vía oral en la dermatomiositis infantil grave. Pacientes y método: Se revisaron retrospectivamente las historias clínicas de los pacientes remitidos al Hospital Materno-Infantil Vall d'Hebron entre 1998 y 2004 con el diagnóstico de dermatomiositis definida y que habían completado 12 meses de tratamiento con tacrolimus. Se evaluaron las respuestas muscular y cutánea mediante las escalas MMT (Manual Muscle Testing)-Kendall, MDAA (Myosits Disease Activity Assessment) y la valoración cutánea de Riley et al. Resultados: El estudio incluyó a 6 pacientes (evolución de 0,16 a 11 años). Al completar el tiempo de estudio se objetivó en todos ellos una mejoría significativa tanto de la afectación muscular como cutánea. No se observaron efectos secundarios y fue posible reducir la dosis diaria de glucocorticoides. Conclusiones: El tacrolimus por vía oral parece ser una opción eficaz y segura en casos de dermatomiositis grave, y especialmente en aquellos con una mayor afectación cutánea
Background and objective: To analize the response to treatment with oral tacrolimus in severe juvenile dermatomyositis. Patients and method: Clinical charts of the patients diagnosed at our hospital as having definite juvenile dermatomyositis between 1998 and 2004, who have completed 12 months of treatment with oral tacrolimus, were reviewed retrospectively. The MMT (Manual Muscle Testing)-Kendall scale, the MDAA (Myosits Disease Activity Assessment), and the Riley et al score were used for the evaluation of the muscular and skin response. Results: The study included 6 patients, (evolution: 0.16-11 years). At the end of the follow-up period (12 months) there was a significant improvement at both, muscular and cutaneous level in all patients. Side effects were not observed. Tapering of the daily corticosteroids dose was also possible. Conclusions: Oral tacrolimus therapy seems to be an effective and safe alternative in cases of severe juvenile dermatomyositis, especially in those with an important cutaneous involvement
