title: Nonspecific interstitial pneumonia/fibrosis completely recovered by adding cyclophosphamide to corticosteroids.
abstract: Nonspecific interstitial pneumonia/fibrosis (NSIP) was first described by Katzenstein and Fiorelli in 1994 (Am J Surg Pathol 18: 136-147). Many reports have described that corticosteroids are effective for NSIP. We describe a case of group II idiopathic NSIP in whom cyclophosphamide was administered since the initial response to corticosteroids had been insufficient. Lung biopsy was performed by video-assisted thoracoscopic surgery and NSIP was diagnosed pathologically, clinically and radiologically. Although the initial response to corticosteroids was insufficient, interstitial infiltrates on chest computed tomography improved dramatically after adding intravenous cyclophosphamide followed by oral cyclophosphamide. This case demonstrates that the addition of cyclophosphamide to corticosteroids might be a useful treatment for patients with NSIP.
authors.affiliation: Department of Respiratory Medicine, Mitoyo General Hospital, Kagawa.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Nanki
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Yamaji
authors.forename: Hiroya
authors.initials: H
authors.lastname: Maeda
authors.forename: Taichi
authors.initials: T
authors.lastname: Kurose
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Kaji
authors.forename: Katashi
authors.initials: K
authors.lastname: Satoh
authors.forename: Katsuya
authors.initials: K
authors.lastname: Miyatani
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yamadori
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ohtsuki
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishida
mesh_terms: D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone