Rapid exacerbation of scleroderma in a patient treated with interleukin 2 and lymphokine activated killer cells for renal cell carcinoma.

A patient with longstanding scleroderma with myositis was treated with interleukin 2 (IL-2) and lymphokine activated killer (LAK) cells for locally metastatic renal cell carcinoma. A rapid progression of truncal skin thickening and muscle weakness occurred within weeks of the initial infusion. Studies using supernatants from peripheral T lymphocytes of patients with scleroderma have shown increased levels of IL-2, IL-2 receptor, IL-4 and B cell growth factors, indications of activation of immune mechanisms. The rapid progression of our patient's illness during immunotherapy suggests a primary role for IL-2 and LAK cells in this disorder. Patients with scleroderma who receive IL-2 and LAK cells should be monitored prospectively for exacerbation of their illness.