An Operated Case of Dermatomyositis with Gastric and Colon Cancer Improved by High Dose Gamma-globulin

Masaaki Ito, Hajime Kase, Akihiko Kouno, Noriyuki Ishii, Naoyasu Saito, Osamu Shimoyama, Yoko Oshima, Kazuo Kobayashi and Michio Akima*

First Department of Surgery and First Department of Pathology*, Toho University School of Medicine

A 64-year-old man admitted to the department of dermatology for dermatomyositis was transferred to our department for gastric and colon cancer. Physical examination showed generalized varied redness and heliotrope eruption in the peripalpebral regions. He had impaired muscular strength of the extremities, and dysphagia. Laboratory examination showed that WBC was 5,400/μ l, CRP 2.1 mg/dl, and CK 5,836 IU/l, and a test for anti-Jo-1 antibody was negative. Preoperative pulsed steroid therapy did not improve dysphagia and skin symptoms, and this prevented surgery. We therefore used high-dose gamma globulin pharmaceutical preparations of 20 g per day for 5 days, and this improved his condition to where total gastrectomy and Hartmann's operation could be done. Prednisolone was reduced after the day of surgery by 10 mg per week. Nevertheless for using of Prednisolone, he could not improve the dysphagia. But by using of preoperatively administered high-dose gamma globulin, we could accomplish operation safely without any complication. It is effective to use high-dose gamma globulin pharmaceutical preparations in order to avoid the post operative complication.

Key words
dermatomyositis, gastric cancer, gamma globulin

Reprint requests
Masaaki Ito First Department of Surgery, Toho University School of Medicine
6-11-1 Oomorinishi, Oota-ku, Tokyo, 143-8541 JAPAN

Accepted
September 22, 2004

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