{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:03:23Z","timestamp":1792724603374,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,11,30]],"date-time":"2010-11-30T00:00:00Z","timestamp":1291075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the long\u2010term outcome of esophageal complications in the group of patients receiving intravenous immunoglobulins (IVIG) for the treatment of severe steroid\u2010refractory esophageal involvement related to polymyositis\/dermatomyositis (PM\/DM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the medical records of 73 patients (39 with PM, 34 with DM) with steroid\u2010resistant esophageal involvement. Esophageal involvement was evaluated by clinical and manometric investigations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010three patients with steroid\u2010refractory esophageal involvement related to PM\/DM received IVIG therapy (2 gm\/kg monthly). The median interval between PM\/DM diagnosis and the onset of esophageal complications was 6 months. The most common clinical manifestations revealing esophageal dysfunction were dysphagia (69.9%), coughing while eating (61.6%), and gastroesophageal reflux into the pharynx and\/or mouth (34.2%). Twenty\u2010five patients exhibited life\u2010threatening esophageal complications requiring exclusive enteral feeding; 33 patients (45.2%) with esophageal impairment developed aspiration pneumonia. Sixty patients (82.2%) exhibited resolution of esophageal clinical manifestations, leading to a return to normal oral feeding and ablation of feeding enteral tubes. Four other patients (5.5%) improved, although they still experienced mild dysphagia intermittently. Because of impaired cricopharyngeal muscle relaxation, another patient successfully underwent cricopharyngeal myotomy. Eight patients died from aspiration pneumonia (n = 6) and cancer (n = 2). Muscle weakness, thoracic myopathy, and aspiration pneumonia were independent predictive factors of IVIG\u2010treated esophageal complications in PM\/DM patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that IVIG should be considered in life\u2010threatening esophageal impairment complicating steroid\u2010resistant PM\/DM. We also suggest that combined therapy of IVIG and high\u2010dose steroids may be the first\u2010line therapy in PM\/DM patients with life\u2010threatening esophageal manifestations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.20325","type":"journal-article","created":{"date-parts":[[2010,8,18]],"date-time":"2010-08-18T23:19:14Z","timestamp":1282173554000},"page":"1748-1755","source":"Crossref","is-referenced-by-count":124,"title":["Intravenous immunoglobulins for steroid\u2010refractory esophageal involvement related to polymyositis and dermatomyositis: A series of 73 patients"],"prefix":"10.1002","volume":"62","author":[{"given":"I.","family":"Marie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u2010F.","family":"Menard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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