Dermatomyositis

NOTES​

• IVIG is great for DM but expensive. ~20k per month.  space out dosing as much as possible, start q2-4wks then decrease frequency (but dont decrease dose)

  • #1 SE is HA (prevent by hydrating and slowing infusion, never faster than 4hrs, and 6-8hrs is better).  Thromboembolism and aseptic meningitis are other SEs.  ITs also given in up to 500cc of fluid so can be problematic for fluid hypersensitive. 

  • No need to check IGA level​

  • decrease in WBC occurs, reason unknown, but not typically dangerous

  • dosing is 1g/kg daily for 2 days consecutively.  for kids, dosed 1g/kg q2 weeks

  • efficacy seen usually in 2-3mo but can be immediate

  • transfusion reactions are rare, but can premed with 650mg tylenol, 50mg benedryl, 30mg methylpred

• about 1/3 of DM patients will get plaquenil rash, 1/40 pts with lupus​

 

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