Aug 7, 2003 - We report the case of an 8-year-old girl with juvenile dermatomyositis, whose disease course rapidly worsened under treatment with an ...
Eur J Pediatr (2003) 162: 725–726 DOI 10.1007/s00431-003-1290-z
SHO RT REPOR T
Gerd M. Lackmann Æ Jenny Ndagijimana Æ Tim Niehues
An unspecific immunostimulating agent and juvenile dermatomyositis: enhanced T-cell proliferation and reverse immunosuppression as a severe adverse drug reaction Received: 22 April 2003 / Accepted: 30 June 2003 / Published online: 7 August 2003 Ó Springer-Verlag 2003
We report the case of an 8-year-old girl with juvenile dermatomyositis, whose disease course rapidly worsened under treatment with an unspecific immunostimulating agent containing large amounts of inosine. An 8-year-old girl had suffered from flat-topped papules over the dorsal interphalangeal joints for 1.5 years. As these papules were considered to be of viral origin, treatment with Delimmun, an unspecific immunostimulating agent containing 379.75 mg dimepranole4-acetoamidobenzoate and 120.25 mg inosine per tablet, was initiated 2 months previously. Under this therapy, the girl developed erythematous, scaling patches on the upper anterior chest and the extensor surfaces of her arms and legs as well as a violaceous erythema of the face in a ‘‘butterfly’’ distribution and purple-red discolouration of the upper eyelids. On admission to hospital, the papules on her hands were recognised as typical, so-called Gottron papules (Fig. 1), which are pathognomonic for dermatomyositis. Laboratory investigations were normal with the exception of slightly elevated transaminases (ASAT 29 U/l, reference range
