Successful treatment with tacrolimus in a case of lung-dominant connective tissue disease.

Abstract

A 49-year-old man with dyspnea was found to have reticular opacities and ground-glass attenuation with traction bronchiectasis or bronchiolectasis on computed tomography. The patient met the criteria for lung-dominant connective tissue disease (LD-CTD) and histopathologically exhibited a chronic fibrotic interstitial pneumonia illustrating framework of a usual interstitial pneumonia-like pattern. Due to worsening of the disease, therapy was initiated with corticosteroids in combination with cyclosporine A. However, treatment with these drugs was ineffective. Pirfenidone and intravenous cyclophosphamide therapy also proved ineffective. The cyclosporine A was therefore switched to tacrolimus, and the patient's disease improved, allowing for a reduction in the dose of the corticosteroids. Our experience in this case suggests that treatment with tacrolimus might be useful for treating refractory LD-CTD even when histopathologically chronic fibrotic interstitial pneumonia is evident.

• Authors: Masaki Okamoto, Kiminori Fujimoto, Masayuki Nakamura, Tsukasa Yoshida, Akiko Idemoto, Yasuhiko Kitasato, Tomotaka Kawayama, Junya Fukuoka, Masao Ichiki, Tomoaki Hoshino
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 52 Issue 5 Pg. 605-9 ( 2013) ISSN: 1349-7235 [Electronic] Japan
• PMID: 23448773 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Tacrolimus

Topics

• Connective Tissue Diseases (diagnosis, drug therapy, pathology)
• Fibrosis
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lung Diseases, Interstitial (diagnosis, drug therapy, pathology)
• Male
• Middle Aged
• Tacrolimus (therapeutic use)
• Treatment Outcome