Tacrolimus as a reinforcement therapy for a patient with MPO-ANCA-associated diffuse alveolar hemorrhage.
A 67-year-old woman, suffering from continuous hemoptysis, was admitted to our hospital where she was managed with mechanical ventilation. Computed tomography of the chest demonstrated bilateral massive alveolar hemorrhage without evidence of infectious disease. She was diagnosed with anti-myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated diffuse alveolar hemorrhage because a high titer of MPO-ANCA was found in the serum. Plasmapheresis as well as methylprednisolone pulse therapy were initiated, followed by intravenous administration of cyclophosphamide. Tacrolimus was employed for the maintenance therapy, and the oral prednisolone dosage could successfully be tapered without recurrence, along with the decrement of the titer of MPO-ANCA.
Kawasaki
Satoko
S
The First Department of Internal Medicine, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
Nakamura
Hideki
H
Honda
Emi
E
Iwanaga
Nozomi
N
Kawakami
Atsushi
A
Ida
Hiroaki
H
Origuchi
Tomoki
T
Honda
Shoko
S
Tsuchihashi
Yoshiko
Y
Yoshimine
Hiroyuki
H
Eguchi
Katsumi
K
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D003131:Combined Modality Therapy; D003520:Cyclophosphamide; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D009195:Peroxidase / Q000276:immunology; D010956:Plasmapheresis; D011239:Prednisolone / Q000627:therapeutic use; D011650:Pulmonary Alveoli / Q000473:pathology; D013902:Radiography, Thoracic; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D009195:Peroxidase; D016559:Tacrolimus