Successful treatment of primary Sjögren's syndrome with chronic natural killer lymphocytosis by high-dose prednisolone and indomethacin farnesil.
We report a patient with Sjögren's syndrome and chronic natural killer lymphocytosis, who developed severe neutropenia, autoimmune hemolytic anemia, and immune thrombocytopenia. High-dose prednisolone therapy improved the hemolytic anemia and thrombocytopenia, but not the CD16(+) CD56(-) NK lymphocytosis completely. Interestingly, indomethacin farnesil (a prodrug of indomethacin) was effective for myalgia and also decreased the number of CD16(+) CD56(-) NK cells. NK lymphocytosis is rarely associated with autoimmune disease, but the combination of indomethacin and steroid therapy may have a favorable effect for such patients.
Fujita
Yoshimasa
Y
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, USA.
Fujii
Takao
T
Takeda
Naho
N
Tanaka
Masao
M
Mimori
Tsuneyo
T
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007213:Indomethacin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007694:Killer Cells, Natural / Q000473:pathology*; D008218:Lymphocytosis / Q000209:etiology* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D012793:Sialadenitis / Q000209:etiology / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D011239:Prednisolone; C060022:indomethacin farnesil; D007213:Indomethacin