A case of systemic sclerosis associated with interstitial pneumonia with various autoantibodies: Improvement by intravenous cyclophosphamide therapy

Abstract

A 41-year-old woman was admitted to Tokyo Women’s Medical College Aoyama Hospital in January 1994. She presented cough and dyspnea in September 1991. The diagnosis of interstitial pneumonia was made based on TBLB. Interstitial pneumonia was responsive to initial prednisolone of 40 mg daily. When dose of prednisolone was reduced to 15 mg daily, she complained of cough and dyspnea again. She was referred to Institute of Rheumatology, Tokyo Women’s Maedical College in November 1993. She was diagnosed as systemic sclerosis associated with interstitial pneumonia based on proximal scleroderma and digital pitting scar. Double immunodiffusion and immunoprecipitation assay revealed the presence of anti-Ki, anti-Wa, and anti-RNA polymerases antibodies in the serum, On admission in March 1994, she was treated with intravenous cyclophosphamide therapy at 500 mg/day once a mouth. After the third infusion, respiratory symptoms, pulmonary function test values, findings of chest X-ray and CT scan were improved without adverse drug effects. Intravenous cyclophosphamide therapy seems to be useful in this case. The efficacy of Intravenous cyclophosphamide therapy in the treatment of the interstitial pneumonia associated with systemic sclerosis was discussed. © 1996, The Japan Society for Clinical Immunology. All rights reserved.