Seventy-one-year-old woman was visited to our hospital because of dry
cough and
dyspnea on effort. Fine
crackle was audible on both lower lung fields. Joints and skin were normal. Laboratory examination revealed elevation of serum LDH and CRP level. Both anti-nuclear antibody and
Jo-1 antibody were negative. Blood gas analysis showed
hypoxia after exercise. Chest
X-ray film showed reticular shadow in both lower lung fields. Chest CT finding showed patchy area of ground glass attenuation, air-space consolidation, and reticular shadow. Scintigram showed diffuse uptake of
Gallium-67 in both lung. Transbronchial biopsy specimen revealed alveolar wall thickness, lymphocyte infiltration and swelling of type II pneumocytes. Bronchoalveolar lavage fluid analysis revealed elevation of CD4/CD8 ratio. She was given a diagnosis of
idiopathic interstitial pneumonia. Combination
therapy of
cyclosporin A and
steroid was performed. After
therapy, her chest CT findings and her data of pulmonary function test were improved. Then
therapy of
cyclosporin A was continued and dose of
prednisolone was gradually decreased. After that, she was suffered from
respiratory tract infection. After administration of
antibiotics and
cyclosporin A, she was getting well without acute exacerbation of
interstitial pneumonia. Since then, she was treated with
cyclosporin A only and her pulmonary function test data were gradually improved more. It suggests that
cyclosporin A may be useful for the treatment of
idiopathic interstitial pneumonia.