title: Oral low-dose tacrolimus therapy for refractory hemophagocytic syndrome associated with systemic lupus erythematosus.
abstract: Hemophagocytic syndrome (HPS) is an unusual disorder associated with systemic lupus erythematosus (SLE). A 64-year-old woman was admitted because of fever and urticarial vasculitis. Laboratory data revealed pancytopenia and immunological abnormalities, suggesting elevated disease activity. Prednisolone monotherapy failed to improve the pancytopenia despite the amelioration of other clinical findings. Because her condition was suggestive of HPS, tacrolimus at 2-3 mg/day was added to the prednisolone regimen. Eventually, the pancytopenia improved and prednisolone could be effectively tapered. Tacrolimus could be an additional or alternative modality for treating refractory HPS.
authors: Department of Rheumatology, Hematology, and Metabolic Diseases, Kyushu University Hospital at Beppu, 4546 Tsurumibaru, Beppu, Oita 874-0838, Japan. watanabe@tsurumi.beppu.kyushu-u.ac.jp
authors: Hideyuki
authors: H
authors: Watanabe
authors: Nobuhisa
authors: N
authors: Hirase
authors: Hideaki
authors: H
authors: Goda
authors: Hiroshi
authors: H
authors: Nishikawa
authors: Shoichiro
authors: S
authors: Ikuyama
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005334:Fever; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010198:Pancytopenia / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D016559:Tacrolimus / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D014657:Vasculitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D016559:Tacrolimus