title: Leukocytapheresis for the treatment of acute exacerbation of idiopathic interstitial pneumonias: a pilot study.
abstract: OBJECTIVE
  Idiopathic interstitial pneumonias (IIPs) are a group of heterogeneous diffuse parenchymal lung disorders of unknown etiology. An acute exacerbation (AE) is an acute respiratory deterioration that occurs in IIPs. The prognosis of AE of IIPs (AE-IIPs) is extremely severe; however, no established therapies exist. We aimed to evaluate the efficacy of leukocytapheresis (LCAP) to treat patients with AE-IIPs.
  
  
  METHODS
  Six chronic IIPs patients who developed AE were enrolled in this study. We performed LCAP on days 2, 3, 9 and 10 in all six patients. All patients were also treated with high-dose corticosteroids and a continuous administration of low-molecular-weight heparin. We observed 30-day survival after the diagnosis of AE to evaluate the efficacy of LCAP. We also assessed oxygenation, high-resolution computed tomography (HRCT) findings, and certain chemical mediators in the peripheral blood.
  
  
  RESULTS
  Five of six patients survived more than 30 days. One patient died of progressive respiratory failure. Oxygenation and HRCT findings tended to improve in all survivors. The serum levels of lactate dehydrogenase, high mobility group box-1, and interleukin-18 were significantly decreased statistically post-LCAP. No severe adverse events occurred.
  
  
  CONCLUSIONS
  We suggest that LCAP is a safe and effective therapy for treating patients with AE-IIPs. J. Med. Invest. 64: 110-116, February, 2017.
authors.affiliation: Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Yamasaki
authors.forename: Miki
authors.initials: M
authors.lastname: Takata
authors.forename: Masato
authors.initials: M
authors.lastname: Morita
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Funaki
authors.forename: Kensaku
authors.initials: K
authors.lastname: Okada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Teruya
authors.forename: Takehito
authors.initials: T
authors.lastname: Fukushima
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D054990:Idiopathic Pulmonary Fibrosis / Q000628:therapy; D018836:Inflammation Mediators / Q000097:blood; D007937:Leukapheresis; D008297:Male; D010865:Pilot Projects
chemical_list: D018836:Inflammation Mediators