Dermatomiositis refractaria asociada a neumonía en organización tratada con rituximab: Reporte de un caso / Refractory dermatomyositis associated with chronic organizing pneumonia treated with rituximab: Report of one case
Rev. méd. Chile
; 137(1): 88-93, ene. 2009. ilus, tab
Article
em Es
| LILACS
| ID: lil-511849
Biblioteca responsável:
BR1.1
ABSTRACT
Chronic organizing pneumonia (COP) has often been reported as a pulmonary manifestation of collagen vascular diseases, mainly rheumatoid arhritis, but the association of COP and dermatomyositis (DM) has rarely been documented. We report a 55 year-old woman with well-documented DM and a COP. She was refractory to steroids and two other immunosuppressive agents therapy (cyclophosphamide and azathioprine). Therefore, rituximab (2 x 1 g infusions) was used for treatment. During the following weeks her strength gradually increased while creatine kinase (CK), C reactive protein and erythrocyte sedimentation rate normalized. After 6 months, she had a relapse with increased muscle enzymes, fever and modérate muscle weakness. After a second course of rituximab (2 x 1 g infusions), the patient demonstrated a remarkable clinical response as indicated by an increase in muscle strength and moderate decline in creatine kinase levels. Lung abnormalities resolved significantly on high resolution chest CT sean. Thus, B-cell depletion therapy with rituximab used alone or in combination with other immunosuppressants may be a viable option in patients with polymyositis-dermatomyositis and pneumonia refractory to current therapies.
Palavras-chave
Texto completo:
1
Índice:
LILACS
Assunto principal:
Doenças Pulmonares Intersticiais
/
Antirreumáticos
/
Dermatomiosite
/
Imunossupressores
/
Anticorpos Monoclonais
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2009
Tipo de documento:
Article