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Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:729-730; doi:10.1136/jnnp.2007.134676
Copyright © 2008 by the BMJ Publishing Group Ltd.

SHORT REPORTS

Spontaneous recovery of dermatomyositis and unspecified myositis in three adult patients

J van de Vlekkert1, J E Hoogendijk2, C J M Frijns2 and M de Visser1

1 Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands
2 Rudolf Magnus Institute for Neuroscience, Department of Neurology, University Medical Centre Utrecht, The Netherlands

Correspondence to:
J van de Vlekkert, Academic Medical Centre, Department of Neurology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; j.vandevlekkert{at}amc.uva.nl

Dermatomyositis (DM), polymyositis and unspecified myositis are idiopathic inflammatory myopathies in which prednisone is usually started as soon as the diagnosis has been established. Therefore, little is known about the natural history of these diseases and spontaneous recovery may escape attention. Here, we present three patients who achieved remission without administration of immunosuppressants. In these three patients, treatment was not started because of spontaneously improving symptoms and signs during the diagnostic process. After 3–5 years, all patients are still free of muscle weakness. These case reports demonstrate that spontaneous long lasting remission can occur in a small proportion of patients with subacute onset idiopathic inflammatory myopathies. In some patients, immunosuppressive treatment with the risk of serious side effects can perhaps be omitted. However, close and frequent monitoring is required in these instances.


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