title: Antithymocyte globulin for a patient with systemic lupus erythematosus complicated by severe pancytopenia.
abstract: 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.
authors.affiliation: First Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
authors.forename: Y
authors.initials: Y
authors.lastname: Matsukawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kura
authors.forename: M
authors.initials: M
authors.lastname: Takei
authors.forename: Y
authors.initials: Y
authors.lastname: Tomita
authors.forename: S
authors.initials: S
authors.lastname: Nishinarita
authors.forename: T
authors.initials: T
authors.lastname: Horie
mesh_terms: 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*
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone