- 著者
- Eri Oguro Shiro Ohshima Akie Kikuchi-Taura Atsuko Murata Kentaro Kuzuya Yasutaka Okita Hidetoshi Matsuoka Satoru Teshigawara Maiko Yoshimura Yuji Yoshida Kentaro Isoda Eriko Kudo-Tanaka Yoshinori Harada Toshio Kaminou Yukihiko Saeki
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.58, no.9, pp.1355-1360, 2019-05-01 (Released:2019-05-01)
- 参考文献数
- 17
- 被引用文献数
- 3 9
A 26-year-old woman with Takayasu's arteritis (TAK) experienced back and neck pain during tocilizumab (TCZ) treatment. The levels of C-reactive protein were normal, and ultrasonography revealed no significant changes. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed signal enhancement in the walls of several arteries. Contrast computed tomography showed arterial inflammation in the same lesion. After increasing the dose of prednisolone and TCZ, all signal enhancements decreased and continued to decrease, as observed on days 76 and 132. Thus, DWIBS may be a novel imaging modality for assessing the disease activity of TAK, particularly during follow-up.
- 著者
- Hideto Kameda Hitoshi Tokuda Fumikazu Sakai Takeshi Johkoh Shunsuke Mori Yuji Yoshida Noboru Takayanagi Hirofumi Taki Yoshinori Hasegawa Kazuhiro Hatta Hisashi Yamanaka Makoto Dohi Shu Hashimoto Hidehiro Yamada Shinichi Kawai Tsutomu Takeuchi Kazuhiro Tateda Hajime Goto
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.50, no.4, pp.305-313, 2011 (Released:2011-02-15)
- 参考文献数
- 25
- 被引用文献数
- 27 60
Objective Acute-onset diffuse interstitial lung disease (AoDILD) in patients with rheumatoid arthritis (RA) has been a serious concern, especially for those under treatment with biological agents which may affect the presentation and outcome of AoDILD, including Pneumocystis pneumonia (PCP). Therefore, we conducted a retrospective, multi-center study of AoDILD in RA patients receiving biological agents. Methods Patients who developed AoDILD while receiving biological agents (infliximab, etanercept, adalimumab and tocilizumab) were enrolled in the study. Definite PCP was defined as patients who showed either P. jirovecii organisms in their respiratory samples by microscopic examination, or positive tests for both P. jirovicii DNA-PCR with respiratory samples and an elevated serum 1,3-β-D-glucan level above the cut-off value. Probable PCP was defined as either a positive test for P. jirovicii PCR or an elevated serum β-D-glucan level. Chest HRCT findings were evaluated and scored by two board-certified radiologists. Results The final diagnoses for 26 patients examined were definite PCP for 13 patients, probable PCP for 11, and methotrexate-associated pneumonitis in 2 patients. Definite and probable PCP cases were clinically indistinguishable. Generalized, diffuse ground-glass opacity (GGO) is the characteristic HRCT finding in patients with definite or probable PCP, which was different from our previous findings in RA patients, mostly without biologics, showing GGO distributed in a panlobular or multilobular manner. The clinical outcome was favorable by treatment with trimethoprim-sulfamethoxazole and glucocorticoids. Conclusion The possibility of PCP should be intensively investigated in RA patients developing AoDILD while receiving biological agents.