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The authors report 2 cases that showed less improvement of dystrophic calcification than we described.1 Because their patients had calcification due to dermatomyositis, the authors assume that IVIg might be a treatment option mainly for dystrophic calcification associated with vascular disease. However, we herein describe another patient with dystrophic calcification who was treated with IVIg for dermatomyositis and who was briefly mentioned in our original article.1
A 53-year old woman with severe skin manifestations and myositis received a second-line treatment with IVIg. In addition, she had large calcium deposits in her hips and buttocks. After a few cycles of IVIg treatment, we were surprised to notice the disappearance of the calcifications. When she had received 14 cycles of the treatment, almost all of the deposits had disappeared. Therefore, we do not think the effect of IVIg therapy on calcification must be confined to patients with vascular disease.
The patient we described in greater detail in our original article1 had experienced a relapse and received 6 additional IVIg cycles under the same treatment regimen. After the first 3 additional cycles, she again showed marked improvement of the inflammation, which completely disappeared after the last 3 additional cycles. Her condition stabilized, and she showed no inflammation. However, radiography showed some calcification in her left index finger, and so we assume that the main effect of IVIg in this condition may be reduction of inflammation by suppression of macrophage activity.
Correspondence: Dr Schanz, University of Tuebingen, Liebermeisterstrasse 25, Tuebingen 72076, Germany (Stefan.schanz@med.uni-tuebingen.de).
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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