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MR Vol.13 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.3 |
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Efficacy of combination treatment with cyclosporin
A and corticosteroids for acute interstitial pneumonitis associated
with dermatomyositis
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| Kenji Nagasaka1, Masayoshi Harigai2, Mutsuto
Tateishi2, Masako Hara2, Yasuyuki Yoshizawa3, Takao Koike4 and Nobuyuki
Miyasaka1 |
(1) Department of Bioregulatory Medicine and
Rheumatology, Graduate School, Tokyo Medical and Dental University,
1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
(2) Institute of Rheumatology, Tokyo Women''s Medical University, Tokyo, Japan
(3) Department of Geriatric and Pulmonary Medicine, Graduate School, Tokyo
Medical and Dental University, Tokyo, Japan
(4) Department of Medicine II, Hokkaido University School of Medicine, Sapporo,
Japan |
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| Received: 07 November 2002 Accepted: 16 December
2002 |
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| Abstract |
| Interstitial pneumonitis (IP) associated with
polymyositis and dermatomyositis (PM/DM) is a serious complication
that affects prognosis. We therefore undertook a retrospective multicenter
study to examine the efficacy of a combination treatment with cyclosporin
A (CsA) and corticosteroids. Fifty-three IP patients with PM/DM (9
PM, 44 DM) were analyzed. Thirty-two patients treated with CsA plus
corticosteroids (9 PM, 23 DM) were included in the study. Four parameters,
i.e., subjective symptoms, ausculatory sound, chest radiographs,
and respiratory index, were serially evaluated. A general evaluation
was performed 4 weeks after the start of the combination treatment.
All patients with PM and chronic IP with DM, and 52% of those with
acute IP with DM were graded as better than partially effective in
the general evaluation. In contrast, all patients graded as progressive
in the general evaluation had acute IP with DM. It is of note that
in acute IP with DM, the survival rate of the group primarily treated
with CsA and corticosteroids from the early stage of their disease
was significantly higher than that of the group initially treated
with corticosteroids alone (P = 0.049). In conclusion, a combination
treatment of CsA and corticosteroids from the early stage of disease
may be advantageous for patients with IP with PM/DM, especially acute
IP with DM. |
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| Key words |
| Cyclosporin A (CsA) - Dermatomyositis (DM) - Interstitial
pneumonitis (IP) - Polymyositis (PM) |
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