levoleucovorin and Dermatomyositis

An association between polymyositis-dermatomyositis (PM/DM) and malignancy has been reported. However, controversy exists regarding a direct causal relationship between the two diseases. We describe a patient who had had PM and subsequently developed non-Hodgkin's lymphoma, and discuss the possibility of their causal relation.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Cyclophosphamide; Dermatomyositis; Doxorubicin; Fatal Outcome; Humans; Leucovorin; Lymphoma, Non-Hodgkin; Male; Methotrexate; Polymyositis; Prednisone; Radiography; Vincristine; Vision Disorders

Topics: Administration, Oral; Antidotes; Aspartate Aminotransferases; Biopsy; Dermatologic Agents; Dermatomyositis; Folic Acid; Hematinics; Humans; Leucovorin; Liver; Methotrexate; Risk Factors

Modern treatment of childhood dermatomyositis with corticosteroids has resulted in greatly improved prognosis and style of life. The immunosuppressive drugs methotrexate and azathioprine have been utilized as ancillary agents in life-threatening disease and in children whose disease could not be adequately controlled with prednisone alone. Two patients are completely well without medication two and seven years after onset; two have received no medications for more than two years and have only subtle signs of any residual illness although they had been profoundly ill for two to three years after the onset of dermatomyositis. A fifth patient, completing the third year of disease, remains ill and continues to require medications but has improved sufficiently to return to regular class in school.

Topics: Azathioprine; Child; Child, Preschool; Dermatomyositis; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Leucovorin; Male; Methotrexate; Prednisone; Remission, Spontaneous