Improvement of irregularity of brain vessel walls in systemic lupus erythematosus by tacrolimus.
Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease that affects multiple organs. Neuropsychiatric SLE develops during the course of the disease in 50% to 74% of SLE patients. The pathogenesis of CNS manifestations is multifactorial. The most common neuropathological finding has, in various studies, been multifocal infarcts. The cerebral vascular lesions in SLE that can cause cerebral infarction can be categorized into thromboembolism and vasculitis. On the other hand, tacrolimus is an immunosuppressive drug used for several autoimmune diseases, which inhibits the calcineurin pathway in T cells and reduces accompanying inflammatory cytokine production. We experienced that treatment of a patient with SLE with tacrolimus and steroid pulse therapy yielded improvement of vasculitis of brain vessels on magnetic resonance angiography. We suggest that tacrolimus may play an important role in the treatment of vasculitis of SLE.
Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Hiromi
H
Kizu
Hiroaki
H
Dobashi
Tomohiro
T
Kameda
Kentaro
K
Susaki
Masahiko
M
Kawanishi
Toshihiko
T
Ishida
D000328:Adult; D001921:Brain / Q000473:pathology*; D019703:Calcineurin / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D005334:Fever; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D013601:T-Lymphocytes / Q000276:immunology; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D014657:Vasculitis / Q000188:drug therapy*
D007166:Immunosuppressive Agents; D019703:Calcineurin; D016559:Tacrolimus