Antithymocyte globulin for a patient with systemic lupus erythematosus complicated by severe pancytopenia.
The clinical use of antithymocyte globulin is rarely reported in patients with rheumatic diseases. We describe the use of this agent in a patient with systemic lupus erythematosus who concomitantly developed severe pancytopenia. High-dose methylprednisolone therapy had been unsuccessful in controlling either the disease exacerbation or the pancytopenia. Antithymocyte globulin and cyclosporin A were therefore administered to achieve immunosuppression. The exacerbation of disease activity was gradually lessened, except for persistent thrombocytopenia and anaemia. Severe and persistent immunosuppression, however, led to a fatal brain abscess. The combined use of both antithymocyte globulin and cyclosporin A induced potent immunosuppression, and should be confined to selected patients with systemic lupus erythematosus, and administered under detailed monitoring.
Morishita
Y
Y
First Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Matsukawa
Y
Y
Kura
Y
Y
Takei
M
M
Tomita
Y
Y
Nishinarita
S
S
Horie
T
T
D000328:Adult; D000741:Anemia, Aplastic / Q000209:etiology / Q000628:therapy; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use*; D001922:Brain Abscess / Q000209:etiology; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000628:therapy*; D008775:Methylprednisolone / Q000627:therapeutic use; D010198:Pancytopenia / Q000209:etiology* / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology*
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone