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April 1979

Childhood Dermatomyositis and PolymyositisTreatment With Methotrexate and Prednisone

Author Affiliations

From the Departments of Pediatrics (Drs Fischer, Rachelefsky, Klein, and Stiehm) and Medicine (Dr Paulus), UCLA School of Medicine, Los Angeles. Dr Fischer is now with the University of Cincinnati, Children's Hospital Medical Center. Dr Klein is now with the Dartmouth Hitchcock Medical Center, Hanover, NH.

Am J Dis Child. 1979;133(4):386-389. doi:10.1001/archpedi.1979.02130040040009

• The conditions of three children with dermatomyositis and one child with polymyositis were treated for nine to 31 months with combined prednisone and intravenous methotrexate (1 mg/kg/wk) when prednisone alone was ineffective in controlling the disease or when there were substantial steroid-related toxic effects. All children showed a major clinical improvement within three months despite concomitant reduction of the prednisone dose. Three children completely recovered; one patient relapsed and died. The toxic effects of methotrexate included elevated liver transaminases (3/4), nausea (2/4), abdominal pain (2/4), bone pain (2/4), mild neutropenia (1/4), and mild pruritus (1/4). Intravenous methotrexate is an effective adjunct to steroid therapy in the treatment of steroid-resistant or life-threatening dermatomyositis-polymyositis or dermatomyositis-polymyositis complicated by severe steroid-related effects.

(Am J Dis Child 133:386-389, 1979)