The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2009;77(5):654-658.
스테로이드 흡입제와 저용량의 cyclophosphamide로 호전된 다발성 근염에 동반된 폐쇄성 세기관지 기질화 폐렴 1예
윤찬영, 송 란, 문기원, 이윤종, 송영욱
Successful treatment of bronchiolitis obliterans organizing pneumonia associated with polymyositis with a steroid inhaler and low-dose cyclophosphamide
Chan Young Yun, Ran Song, Ki won Moon, Yun Jong Lee, Yeong Wook Song


Abstract
Polymyositis is an inflammatory connective tissue disease involving, predominantly, skeletal muscle. Occasionally, it is complicated by serious interstitial pneumonia. The presence of interstitial pneumonia affects the prognosis and contributes substantially to the morbidity and mortality. Although the treatment recommendations for interstitial pneumonia in polymyositis are still not optimal, high-dose steroid or immunosuppressive agents such as methotrexate, azathioprine, cyclosporine A, or cyclophosphamide alone or in combination are effective in myositis-associated interstitial pneumonia in many cases. Nevertheless, the relative frequency of complications, such as opportunistic infection, steroid-induced myopathy, and steroid psychosis, limits the use of high-dose steroid or immunosuppressive regimens. Here, we describe our experience of combination treatment with a steroid inhaler and low-dose cyclophosphamide in a patient with bronchiolitis obliterans organizing pneumonia associated with polymyositis who developed steroid-induced myopathy during initial high-dose steroid and cyclosporine A treatment.

Keywords :Polymyositis, Bronchiolitis obliterans organizing pneumonia, Steroid-induced myopathy, Steroid inhaler
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