Abstract
Aggressive autoimmune diseases are often treated by intensive immunosuppressive treatment such as high-dose methylprednisolone and intravenous cyclophosphamide. Autologous hematopoietic stem cell transplantation can facilitate high-dose immunosuppressive therapy (HDIT), which is myeloablative. We describe a 54-year-old female patient with rapidly progressive and refractory interstitial pneumonia due to dermatomyositis, which was successfully treated with high-dose cyclophosphamide and autologous blood stem cell transplantation. Following transplantation, dyspnea disappeared, and arterial blood gas analysis and respiratory function test showed marked improvement. This improvement was confirmed by diminished interstitial shadows on chest X-ray and computed tomography scans. Eighteen months after transplantation, the patient is doing well without symptoms and signs of interstitial pneumonia.
This is a preview of subscription content, log in via an institution to check access.
References
Bohan A, Peter JB (1975) Polymyositis and dermatomyositis. N Engl J Med 292:344–347
Fergusson RJ, Davidson NM, Nuki G, Crompton GK (1983) Dermatomyositis and rapidly progressive fibrosing alveolitis. Thorax 38:71–72
Takizawa H, Suzuki N, Yanagawa T et al (1995) Pulmonary involvement of collagen vascular diseases: studies on prognostic factors from basic and clinical view points (in Japanese). Jpn J Thorac Dis 33 [Suppl]:S291–S295
Miyake S, Ohtani Y, Sawada M et al (2002) Usefulness of cyclosporin A on rapidly progressive interstitial pneumonia in dermatomyositis. Sarcoidosis Vasc Diffuse Lung Dis 19:128–133
Openshaw H, Nash RA, McSweeney PA (2002) High-dose immunosuppression and hematopoietic stem cell transplantation in autoimmune disease: clinical review. Biol Blood Marrow Transplant 8:233–248
Cosnes A, Amaudric F, Gherardi R, Verroust J, Wechsler J, Revuz J, Roujeau JC (1995) Dermatomyositis without muscle weakness. Long-term follow-up of 12 patients without systemic corticosteroids. Arch Dermatol 131:1381–1385
Tyndall A, Passwag J, Gratwohl A (2001) Haematopoietic stem cell transplantation in the treatment of severe autoimmune diseases 2000. Ann Rheum Dis 60:702–707
Baron F, Ribbens C, Kaye O, Fillet G, Malaise M, Beguin Y (2000) Effective treatment of Jo-1 associated polymyositis with T-cell depleted autologous peripheral blood stem cell transplantation. Br J Haematol 110:339–342
Bingham S, Griffiths B, McGonagle D, Snowden JA, Emery P (2001) Autologous stem cell transplantation for rapidly progressive Jo-1-positive polymyositis with long-term follow-up. Br J Haematol 113:840–841
Asahara E, Shimazaki C, Yamagata N et al (1994) Reconstitution of lymphocyte subsets after peripheral blood stem cell transplantation: two color flow cytometric analysis. Bone Marrow Transplant 13:377–381
Kohno N (1999) Serum marker KL-6/MUC1 for the diagnosis and management of interstitial pneumonitis. J Med Invest 46:151–158
Bandoh S, Fujita J, Ohtsuki Y, Ueda Y, Hojo S, Tokuda M, Dobashi H, Kurata N, Yoshinouchi T, Kohno N, Takahara J (2000) Sequential changes of KL-6 in sera of patients with interstitial pneumonia associated with polymyositis/dermatomyositis. Ann Rheum Dis 59:257–262
Kubo M, Ihn H, Yamane K, Kikuchi K, Yazawa N, Soma Y, Tamaki K (2000) Serum KL-6 in adult patients with polymyositis and dermatomyositis. Rheumatology 39:632–636
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Oryoji, K., Himeji, D., Nagafuji, K. et al. Successful treatment of rapidly progressive interstitial pneumonia with autologous peripheral blood stem cell transplantation in a patient with dermatomyositis. Clin Rheumatol 24, 637–640 (2005). https://doi.org/10.1007/s10067-005-1109-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-005-1109-6