Vol.18 No.2

Case Report

Tacrolimus-induced lung injury in a rheumatoid arthritis patient with interstitial pneumonitis

Authors

Yusuke Miwa1 , Takeo Isozaki1 , Kuninobu Wakabayashi1 , Tsuyoshi Odai1 , Mizuho Matsunawa1 , Nobuyuki Yajima1 , Masao Negish1 , Hirotsugu Ide1 , Tsuyoshi Kasama1 , Mitsuru Adachi1 , Tomoyuki Hisayuki2 , Tamiko Takemura3

  • Division of Rheumatology and Clinical Immunology, First Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan
  • First Department of Pathology, Showa University School of Medicine, Tokyo, Japan
  • Department of Pathology, Japanese Red Cross Medical Center, Tokyo, Japan
Received:

4 July 2007

Accepted:

14 November 2007

Published online:

29 February 2008

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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.

Key words

Rheumatoid arthritis - Tacrolimus - Interstitial pneumonitis