Successful treatment with tacrolimus of progressive interstitial pneumonia associated with amyopathic dermatomyositis refractory to cyclosporine.

Clinical Rheumatology
Masaru AndoToshihide Kumamoto

Abstract

A 58-year-old male was admitted to our hospital because of periungual nailfold an erythema and erythematous rash on the dorsal joints of his hands and feet, but no muscle weakness. He was thus diagnosed to have amyopathic dermatomyositis. He had moderate hypoxemia and his chest computed tomography scans demonstrated bilateral ground-glass opacities, implicating complication with interstitial pneumonia. Therapy was initiated with pulsed methylprednisolone followed by high-dose corticosteroids, pulsed cyclophosphamide, and cyclosporine. The skin manifestations improved; however, the pulmonary infiltrates and hypoxemia deteriorated during the 2-month period of the treatment. The treatment was switched from cyclosporine to tacrolimus because of an inadequate clinical response to the therapy, and this resulted in the resolution of interstitial pneumonia. This case indicates that tacrolimus administration should be considered for patients with this life-threatening disorder when it is judged to be refractory to cyclosporine.

Associated Clinical Trials

References

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Citations

Sep 10, 2011·Modern Rheumatology·Yuko MatsukiAkio Mimori
Sep 10, 2010·Current Opinion in Rheumatology·Ane Labirua, Ingrid E Lundberg
Sep 10, 2010·Current Opinion in Rheumatology·Shinji Sato, Masataka Kuwana
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Mar 2, 2013·Internal Medicine·Masaki OkamotoTomoaki Hoshino
Oct 1, 2010·Current Opinion in Rheumatology

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