Ohe Masashi, Shida Haruki, Horita Tetsuya, Ito Kenichiro, Sugiura Mitsuru, Hattori Atsuo, Oku Kenji
Department of Internal Medicine, JCHO Hokkaido Hospital.
Department of Respiratory Medicine, JCHO Hokkaido Hospital.
Drug Discov Ther. 2017;11(4):218-222. doi: 10.5582/ddt.2017.01043.
Macrolides have anti-inflammatory effects and have been used to treat diffuse panbronchiolitis, bronchiectasis, and cystic fibrosis. Lately, several cases of cryptogenic organizing pneumonia (COP) and radiotherapy-related organizing pneumonia (OP) that were successfully treated with macrolides considering their anti-inflammatory effects were reported. We report three cases of OP associated with rheumatoid arthritis (RA) successfully treated with clarithromycin (CAM) and prednisolone (PSL). Case 1: A 70-year-old woman suffering from RA was admitted with cough and severe dyspnea. She was diagnosed with OP associated with RA on the basis of computed tomography (CT) findings and transbronchial lung biopsy results. She was successfully treated with PSL and cyclosporine A. At the exacerbation of OP, she was successfully treated with CAM and PSL. Case 2: A 74-year-old man suffering from COP visited our department with arthralgia and articular swellings. He was diagnosed with RA, which was thought to be associated with OP. He was successfully treated with CAM and PSL. Case 3: A 54-year-old man suffering from RA presented with an exacerbation of arthralgia and articular swellings and cough. He was diagnosed with OP associated with RA on the basis of CT findings. He was successfully treated with CAM and PSL. The present cases suggest that CAM and PSL treatment may be effective in some cases of OP associated with RA.
大环内酯类药物具有抗炎作用，已被用于治疗弥漫性泛细支气管炎、支气管扩张症和囊性纤维化。最近，有几例隐源性机化性肺炎（COP）和放疗相关的机化性肺炎（OP）考虑到其抗炎作用而用大环内酯类药物成功治疗的病例报道。我们报告了3例用克拉霉素（CAM）和泼尼松龙（PSL）成功治疗的类风湿关节炎（RA）相关的OP病例。病例1：一名70岁患RA的女性因咳嗽和严重呼吸困难入院。根据计算机断层扫描（CT）结果和经支气管肺活检结果，她被诊断为RA相关的OP。她先用PSL和环孢素A成功治疗。在OP加重时，她用CAM和PSL成功治疗。病例2：一名74岁患COP的男性因关节痛和关节肿胀前来我科就诊。他被诊断为RA，被认为与OP有关。他用CAM和PSL成功治疗。病例3：一名54岁患RA的男性出现关节痛、关节肿胀加重和咳嗽。根据CT结果，他被诊断为RA相关的OP。他用CAM和PSL成功治疗。目前的病例表明，CAM和PSL治疗可能对某些RA相关的OP病例有效。
