Polymyositis & Dermatomyositis Support Group

Polymyositis (PM) is a type of chronic inflammation of the muscles (inflammatory myopathy) related to dermatomyositis and inclusion body myositis. The inflammation is predominantly of the endomysium in polymyositis, whereas dermatomyositis is characterized by primarily perimysial inflammation.

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I don't understand??

heliconia
heliconia
I copied the following info from TMA web site. It calls Methotrexate an immunsuppresant which to me means it lowers the immune response and then says that IVIG boosts the body's immune response. can this be right? How can they do opposite functions and are both used to treat myositis? Can somebody please explain this to me?

Immunosuppressants: Methotrexate and azathioprine are often introduced as second-line medicines or used in combination with prednisone. This allows patients to taper off prednisone more quickly and hopefully avoid some of the unwanted effects. Both methotrexate and azathioprine are well-tolerated, but methotrexate tends to work faster.
Intravenous immune globulin (IVIG): IVIG is a blood product derived from large pools of donated human plasma. IVIG boosts the body's immune system response, and doctors don't know the exact reasons IVIG works in some myositis patients. IVIG is usually reserved for cases resistant to other treatments, and people with inclusion-body myositis typically do not benefit from IVIG unless they have accompanying swallowing problems.
nanny1611
nanny1611
I don't have the answer to your question, but have wondered the same thing myself. I know that most doctors believe that autoimmune diseases are caused by an overactive immune system that attacks some part of a person's body. However, it seems to me that most people get an autoimmune disease when their immune systems are compromised in some way, which makes me question whether the immune system actually goes into overdrive, or simply goes awry because it's sick. I'll be interested in seeing what others post here in response to your question. Hopefully we'll all learn something new.
lexisgirl
lexisgirl
I'm not expert but my understanding is Prednisone and Methotrexate (and similar drugs) control the disease by suppressing our immune system so it doesn't attack itself (auto-immune disease). IVIG you are borrowing someone else's immune system for a period of time thus boosting your immunity and supplementing our own system with someelse's.

Personally, I am not excited for IVIG because it is a blood plasma product from strangers. While I am sure it is safe, I don't always trust the blood bank and the people that are suppose to protect us. Especially when our immune system isn't healthy.
angie1026
angie1026
I dont understand any of it. My wbc count has always been low. My doc said years ago that this could be indicative of an auto immune disease but since nothing else came up abnormal, he just ignored it. My ANA is still negative despite my muscle biopsy confirming DM. I have always wondered why exactly I'm on an immune suppressant when my wbc count is already lower than normal. I'm sure there is an explanation but I dont know what it is.
brendacaytonwhite
brendacaytonwhite
My understanding which may not be correct is that the Prednisone is to allow me to function from day to day and the Cellcept which I am on is to suppress my autoimmune system so that my muscles can heal. From what was explained to me by my Neurologist they do not work against each other, but do totally opposite things for me. It is very confusing at times, but I have to ask each doctor to explain to me in simple terms so that I can be sure of what it happening to my body. I know that as I increase the Cellcept, the Prednisone will be decreased and I don't look forward to that, but I will get through that also.
deleted_user
deleted_user
I agree with Lexisgirl that IVIG does build up your immune system as it has healthy antibodies whereas pred/cellcept/immuran suppress the immune system and often IVIG is not using the first line of drug.
Hope that helps
Love Hugs and Prayers :-)
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