Chang Hyun Kyu, Park Wann, Ryu Dae Sik
Department of Internal Medicine, University of Ulsan Asan-Kangnung Hospital, Korea.
J Korean Med Sci. 2002 Apr;17(2):270-3. doi: 10.3346/jkms.2002.17.2.270.
Treatment of interstitial lung disease (ILD) in rheumatoid arthritis (RA) has been controversial. Although there have been several anecdotal reports on the efficacies of corticosteroids or cytotoxic agents such as methotrexate, cyclophosphamide, azathioprine, and D-penicillamine for the treatment of ILD associated with RA, no controlled studies have been performed. To date, corticosteroids have been a central agent for the treatment of this disease, but their effects are partial and temporary in most cases. In addition, the adverse effects of these agents are considerable. On the other hand, limited information is available on the cyclosporine use in ILD associated with RA. We describe a 49-yr old female patient with RA and ILD that had initially responded to high dose prednisolone and cyclophosphamide intravenous pulse therapy, and the lung disease was aggravated with the tapering of prednisolone. After 10 months of follow-up loss, the patient was successfully treated with low dose cyclosporine without high dose corticosteroids.
类风湿关节炎（RA）合并间质性肺疾病（ILD）的治疗一直存在争议。尽管有一些关于皮质类固醇或细胞毒性药物（如甲氨蝶呤、环磷酰胺、硫唑嘌呤和青霉胺）治疗与RA相关的ILD疗效的轶事报道，但尚未进行对照研究。迄今为止，皮质类固醇一直是治疗这种疾病的主要药物，但在大多数情况下，它们的效果是部分的且是暂时的。此外，这些药物的不良反应相当大。另一方面，关于环孢素在与RA相关的ILD中的应用信息有限。我们描述了一名49岁患有RA和ILD的女性患者，该患者最初对高剂量泼尼松龙和环磷酰胺静脉脉冲疗法有反应，但随着泼尼松龙剂量的逐渐减少，肺部疾病加重。在随访失访10个月后，该患者成功地接受了低剂量环孢素治疗，未使用高剂量皮质类固醇。
