C/o prox ms weakness.. shud we start another MAB or inc steroid dose




Hello mam,it's better to say history in details , myositis profile,how you use steroid ,total duration of illness,did u rule out common malingancy .relapse means tell in details ,power muscle ,neck muscle , pharyngeal muscle.any muscle biopsy done that time.you can take help of Rheumatologist for better management Common cause of relapse ,rapid tapering of steroid ,and not hiking methotrexate dose. Rituximab not well studied in myositis,it's reserved drug in refractory cases.

Why was rituximab given as right upfront....is she having interstitial lung disease? Single cycle consists of 1 gram followed by similar dose 2 weeks later.... 2nd cycle given in similar fashion 6 months later....So u mean to say 2 such cycles given? Is she having pharyngeal weakness also now? We have to consider adding methotrexate or azathioprine or mmf depending on presence of ILD and increase steroids Kindly share ANA, ENA , muscle enzymes report...

Rituximab was started after giving methotrexate for sometime . Then 2 cycles of Rituximab given Now no ILD /pharyngeal weakness . As soon as i get reports I'll share sir

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