Soga T, Hagiwara E, Shirai A, Igarashi T, Ishigatsubo Y, Okubo T
First Department of Internal Medicine, Yokohama City University School of Medicine.
Nihon Rinsho Meneki Gakkai Kaishi. 1996 Apr;19(2):157-62. doi: 10.2177/jsci.19.157.
We describe a case of interstitial pneumonitis associated with polymyositis who responded well to cyclosporine therapy. In October, 1993, a 49-year-old female was admitted to our hospital because of fever, muscle weakness and progressive dyspnea. Interstitial pneumonitis with polymyositis was diagnosed and daily oral steroid therapy was started. As the therapy was ineffective, pulse intravenous steroid therapies followed by oral cyclophosphamide and steroid therapy was given. Whereas serum levels of muscle enzymes decreased, she became progressively hypoxemic. No effect was observed in series of therapy including additional pulse steroid therapy, pulse intravenous cyclophosphamide therapy, oral azathioprine and oral bethametazone therapy. In April, 1994, oral cyclosporine was started. After daily oral cyclosporine was combined with steroid, her symptoms, chest X-ray, chest CT and pulmonary function tests significantly improved. Her disease became stable and there was no signs of recurrence since then. It is suggested that cyclosporine is useful for the treatment of progressive interstitial pneumonitis associated with polymyositis.
我们描述了一例与多发性肌炎相关的间质性肺炎患者,该患者对环孢素治疗反应良好。1993年10月,一名49岁女性因发热、肌肉无力和进行性呼吸困难入住我院。诊断为间质性肺炎合并多发性肌炎,并开始每日口服类固醇治疗。由于治疗无效,随后给予脉冲静脉注射类固醇治疗,接着口服环磷酰胺和类固醇治疗。尽管肌肉酶的血清水平下降,但她的低氧血症却逐渐加重。包括额外的脉冲类固醇治疗、脉冲静脉注射环磷酰胺治疗、口服硫唑嘌呤和口服倍他米松治疗在内的一系列治疗均未观察到效果。1994年4月,开始口服环孢素。在每日口服环孢素与类固醇联合使用后,她的症状、胸部X线、胸部CT和肺功能测试均有显著改善。她的病情趋于稳定,此后未出现复发迹象。提示环孢素对治疗与多发性肌炎相关的进行性间质性肺炎有效。