Korean J Clin Pharm.  2017 Sep;27(3):195-197. 10.24304/kjcp.2017.27.3.195.

A Case of Rheumatoid Arthritis accompanied by Organizing Pneumonia Successfully Treated with Prednisolone, Clarithromycin and Tacrolimus

Affiliations
  • 1Department of Internal Medicine, JCHO Hokkaido Hospital, Sapporo 062-8618, Japan. masshi@isis.ocn.ne.jp

Abstract

A 74-year-old man suffering from cryptogenic organizing pneumonia (OP) visited our department with arthralgia accompanied with partial swellings of proximal interphalangeal and metacarpophalangeal joints with morning stiffness. A diagnose of rheumatoid arthritis (RA) was made. It was thought that OP was associated with RA. We initiated a treatment with salazosulfapyridine and loxoprofen for RA. Although this treatment was effective, it was discontinued due to the development of drug eruption. As an alternative, the patient was treated with prednisolone (PSL) and clarithromycin (CAM). This treatment demonstrated being effective for OP and RA, to a certain extent; however, the RA activity was not completely suppressed. In order to suppress the RA activity further, tacrolimus (TAC) was successfully added with increasing the dosage of CAM that is assumed to raise blood TAC concentrations. The present case shows that treatment with PSL, CAM and TAC may be effective in some cases of RA.

Keyword

Rheumatoid arthritis; prednisolone; clarithromycin; tacrolimus

MeSH Terms

Aged
Arthralgia
Arthritis, Rheumatoid*
Clarithromycin*
Cryptogenic Organizing Pneumonia
Drug Eruptions
Humans
Metacarpophalangeal Joint
Pneumonia*
Prednisolone*
Sulfasalazine
Tacrolimus*
Clarithromycin
Prednisolone
Sulfasalazine
Tacrolimus
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