Tacrolimus-induced lung injury in a rheumatoid arthritis patient with interstitial pneumonitis.
A 74-year-old woman was experiencing rheumatoid arthritis complicated with interstitial pneumonitis (IP), and tacrolimus treatment was started. She presented with dyspnea. Chest X-ray and computed tomography (CT) showed ground-glass opacity and IP. Although tacrolimus was stopped, she died of respiratory failure. At autopsy, both the upper and lower lung fields showed usual IP and the organizing stage of diffuse alveolar damage. The former is common, but the latter is uncommon, suggesting tacrolimus may cause severe alveolar damage.
Miwa
Yusuke
Y
Division of Rheumatology and Clinical Immunology, First Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan. y.miwa@mbf.ocn.ne.jp
Isozaki
Takeo
T
Wakabayashi
Kuninobu
K
Odai
Tsuyoshi
T
Matsunawa
Mizuho
M
Yajima
Nobuyuki
N
Negishi
Masao
M
Ide
Hirotsugu
H
Kasama
Tsuyoshi
T
Adachi
Mitsuru
M
Hisayuki
Tomoyuki
T
Takemura
Tamiko
T
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000473:pathology; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016559:Tacrolimus