Successful treatment using cyclosporine A plus corticosteroid therapy in an elderly patient with severe idiopathic interstitial pneumonia

Abstract

An 81‐year‐old woman was referred to our hospital due to acute progressive respiratory failure. Her chest X‐ray film showed bilateral interstitial changes and computed tomography revealed a diffuse ground‐glass appearance. Histological examination of transbronchial lung biopsy specimens did not provide a final diagnosis. The patient was diagnosed as having idiopathic interstitial pneumonia (IIP) and was treated with corticosteroid therapy. The chest X‐ray appearance improved temporarily after corticosteroid therapy, but the interstitial changes did not resolve and subsequently became worse again, so administration of cyclosporine A was added. After commencement of cyclosporine A, corticosteroid therapy could be gradually tapered over 10 months. This case suggests that a combination of steroid therapy with cyclosporine A is effective for severe IIP of unknown pathological diagnosis.