Leukocytapheresis for the treatment of acute exacerbation of idiopathic interstitial pneumonias: a pilot study
| Autor: | Kiyoshi Hashimoto, Akihiro Yamamoto, Miki Takata, Takehito Fukushima, Eiji Shimizu, Masato Morita, Akira Yamasaki, Yoshihiro Funaki, Yasuhiko Teruya, Kensaku Okada |
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| Rok vydání: | 2017 |
| Předmět: |
idiopathic interstitial pneumonia
Male medicine.medical_specialty Exacerbation Pilot Projects 030204 cardiovascular system & hematology Gastroenterology nonspecific interstitial pneumonia General Biochemistry Genetics and Molecular Biology Lung Disorder 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Idiopathic Interstitial Pneumonias Leukapheresis Respiratory system Adverse effect Idiopathic interstitial pneumonia acute exacerbation Aged Aged 80 and over business.industry General Medicine Heparin Oxygenation medicine.disease Idiopathic Pulmonary Fibrosis 030228 respiratory system Acute Disease Etiology Physical therapy Female leukocytapheresis Inflammation Mediators business medicine.drug |
| Zdroj: | The Journal of Medical Investigation. 64:110-116 |
| ISSN: | 1349-6867 1343-1420 |
| DOI: | 10.2152/jmi.64.110 |
| Popis: | Objective Idiopathic interstitial pneumonias (IIPs) are a group of heterogeneous diffuse parenchymal lung disorders of unknown etiology. An acute exacerbation (AE) is an acute respiratory deterioration that occurs in IIPs. The prognosis of AE of IIPs (AE-IIPs) is extremely severe; however, no established therapies exist. We aimed to evaluate the efficacy of leukocytapheresis (LCAP) to treat patients with AE-IIPs. Patients and methods Six chronic IIPs patients who developed AE were enrolled in this study. We performed LCAP on days 2, 3, 9 and 10 in all six patients. All patients were also treated with high-dose corticosteroids and a continuous administration of low-molecular-weight heparin. We observed 30-day survival after the diagnosis of AE to evaluate the efficacy of LCAP. We also assessed oxygenation, high-resolution computed tomography (HRCT) findings, and certain chemical mediators in the peripheral blood. Results Five of six patients survived more than 30 days. One patient died of progressive respiratory failure. Oxygenation and HRCT findings tended to improve in all survivors. The serum levels of lactate dehydrogenase, high mobility group box-1, and interleukin-18 were significantly decreased statistically post-LCAP. No severe adverse events occurred. Conclusion We suggest that LCAP is a safe and effective therapy for treating patients with AE-IIPs. J. Med. Invest. 64: 110-116, February, 2017. |
| Databáze: | OpenAIRE |
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