Acute respiratory distress syndrome secondary to antisynthetase syndrome is reversible with tacrolimus.
Polymyositis and interstitial lung diseases, predominantly nonspecific interstitial pneumonia (NSIP), are known to be frequent in antisynthetase syndrome, where anti-aminoacyl-tRNA synthetase antibodies are often identified. An unusual case of acute respiratory distress syndrome, secondary to such proven NSIP of cellular type with predominant CD8 lymphocytes, is described herein. The patient described in the present case study initially had a poor recovery with high dose of steroids, but this was followed by a good improvement after the prescription of tacrolimus and a low dose of prednisone. A precise diagnosis in similar circumstances may be life-saving, allowing the successful application of new immunosuppressants.
Guglielmi
S
S
Clinic and Policlinic for Pneumology, Bern University Hospital, Bern, Switzerland.
Merz
T M
TM
Gugger
M
M
Suter
C
C
Nicod
L P
LP
D000974:Antibodies, Antinuclear / Q000737:chemistry; D001323:Autoantibodies / Q000032:analysis*; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism; D016572:Cyclosporine / Q000494:pharmacology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000188:drug therapy*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology*; D013577:Syndrome; D016559:Tacrolimus / Q000494:pharmacology / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus