Takahashi Takehiro, Asano Yoshihide, Sunaga Ryo, Ichimura Yohei, Taniguchi Takashi, Yamamoto Mizuho, Tamaki Zenshiro, Takekoshi Tomonori, Mitsui Hiroshi, Sugaya Makoto, Ohse Takamoto, Sato Shinichi
Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
J Dermatol. 2014 Jun;41(6):533-5. doi: 10.1111/1346-8138.12495. Epub 2014 May 10.
Interstitial lung disease and scleroderma renal crisis are major complications of systemic sclerosis, which occasionally coexist in patients with the diffuse cutaneous subtype. We herein report a case of diffuse cutaneous systemic sclerosis under hemodialysis due to a previous history of scleroderma renal crisis, whose interstitial lung disease was effectively and safely treated with a half dose of i.v. cyclophosphamide pulse. The dose of cyclophosphamide and the timing of hemodialysis leading to efficacy and low toxicity are discussed.
间质性肺病和硬皮病肾危象是系统性硬化症的主要并发症,在弥漫性皮肤亚型患者中偶尔会同时出现。我们在此报告一例因既往有硬皮病肾危象病史而接受血液透析的弥漫性皮肤系统性硬化症患者,其间质性肺病通过静脉注射半量环磷酰胺脉冲治疗得到有效且安全的控制。本文还讨论了环磷酰胺的剂量以及血液透析的时机,以实现疗效和低毒性。