title: Usefulness of cyclosporine A on rapidly progressive interstitial pneumonia in dermatomyositis.
abstract: BACKGROUND
  Interstitial pneumonia in polymyositis and dermatomyositis (PM/DM) is recognized to be a major complication of PM/DM. Rapidly progressive interstitial pneumonia (RPIP) in DM is frequently refractory to steroids and is the prognosis-determining factor in DM. Recently cyclosporine A (CyA) has emerged as an available treatment for interstitial pneumonia in PM/DM, but its efficacy on RPIP is unclear.
  
  
  OBJECTIVE
  To evaluate the usefulness of CyA in the treatment of RPIP in DM.
  
  
  METHODS
  We reviewed the medical charts of 10 cases with RPIP in DM to whom CyA was administered.
  
  
  CONCLUSIONS
  Combined administration of oral CyA and steroids with/without immuno-suppressants was likely to be beneficial in 4 of 10 cases that were refractory to the conventional preceding therapy. The values of PaO2/FIO2 when CyA were initiated were suggested to be a prognosis-determining factor for the outcome of the disease, showing that initiation of CyA should be considered in the early stage of RPIP in DM. The dosage of steroids was tapered in 3 out of 4 CyA-responsive cases without re-exacerbation. Therefore administration of CyA might be useful in lowering the dosage of steroids.
authors.affiliation: Pulmonary Medicine, Tokyo Medical and Dental University, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Miyake
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohtani
authors.forename: Megumi
authors.initials: M
authors.lastname: Sawada
authors.forename: Naohiko
authors.initials: N
authors.lastname: Inase
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Shogo
authors.initials: S
authors.lastname: Takano
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyasaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yoshizawa
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone