jkra The Journal of the Korean Rheumatism Association J Korean Rheum Assoc 1226-8070 2233-4718 The Korean Rheumatism Association 10.4078/jkra.2009.16.4.301 jkra-16-301 Original Article A Case of Resistant Polymyositis That Was Successfully Treated with Tacrolimus AhnYong Woo 1 SongSungheon 1 HwangKyu Sig 1 YooDae-Hyun 2 KimNa Rae 3 KimTae-Hwan 2 Department of Internal Medicine, Department of Internal Medicine, Hanyang University, Seoul, Korea The Hospital for Rheumatic Diseases, College of Medicine, Hanyang University, Seoul, Korea Department of Pathology, Gachon Medical School, Incheon, Korea 01 2009 20 01 2009 16 4 301 305 19062009 01082009 10082009 Copyright © 2009 The Korean Rheumatism Association 2009 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Polymyositis is one form of inflammatory myopathy. In some patients, this disease does not entirely respond to conventional initial therapy with glucocorticoid, methotrexate and azathioprine. Multiple options exist for treating these patients, but only intravenous immune globulin has been subjected to a randomized clinical trial. We report here on a case of polymyositis that did not respond to multiple drug therapy, but it did respond to tacrolimus. After treatment with tacrolimus, the patient's disease has been well controlled for many years.

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Minimal infiltration of inflammatory cells is found in the endomysial area (H&E stain, ×400).

The serum CK and LDH levels during treatments ∗PDS (tapering from 1 mg/kg/day),†IVIG (400 mg/day for∥Cyclosporine (100§Methotrexate (10 mg/week),‡Cyclophosphamide (50 mg/day), 5 consecutive days), mg/day),Azathioprin (100 mg/day), ∗∗Infliximab (300 mg, 1 day),††Tacrolimus (2 mg/day), ↓: IVIG.