Treatment of Lupus Interstitial Lung Disease with Intravenous Cyclophosphamide

✍ Scribed by Arnold R. Eiser; Harvey M. Shanies

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 412 KB
• Volume: 37
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780370318

✦ Synopsis

Intravenous pulse cyclophosphamide (IPC) was used to treat lupus interstitial lung disease in 2 patients. Vital capacity increased by 67-110% of baseline values with IPC treatment. Total lung capacity and diffusing capacity also improved. Dyspnea and other manifestations of lupus improved dramatically. This is the first report documenting the efficacy of the early use of IPC for acute and chronic interstitial lung disease associated with lupus.

Systemic lupus erythematosus (SLE) can produce an acute and chronic interstitial pneumonitis which is accompanied by substantial morbidity and mortality (1-5). Initial treatment of lupus pneumonitis has generally consisted of corticosteroid therapy, with cytotoxic agents and plasmapheresis being reserved for refractory cases late in the course (6-9).

The efficacy of intravenous pulse cyclophosphamide (IPC) is superior to that of corticosteroids in preserving renal function in patients with severe lupus nephritis (10-12). We report here two cases of SLE pneumonitis with severe restrictive impairment in which there was incremental improvement following several courses of IPC. These are the first cases documenting improvement following such therapy.