title: Tacrolimus-induced lung injury in a rheumatoid arthritis patient with interstitial pneumonitis.
abstract: 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.
authors.affiliation: Division of Rheumatology and Clinical Immunology, First Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan. y.miwa@mbf.ocn.ne.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miwa
authors.forename: Takeo
authors.initials: T
authors.lastname: Isozaki
authors.forename: Kuninobu
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Odai
authors.forename: Mizuho
authors.initials: M
authors.lastname: Matsunawa
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yajima
authors.forename: Masao
authors.initials: M
authors.lastname: Negishi
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ide
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kasama
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hisayuki
authors.forename: Tamiko
authors.initials: T
authors.lastname: Takemura
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus