no abstract avaliable

No abstract available.
Myelodysplastic Syndromes

No abstract available.
Chylous Ascites ; Lymphoma, Follicular

A 41-year-old man suffering from eosinophilic granulomatosis with polyangiitis (EPGA), diagnosed at another clinic on the basis of American College of Rheumatology Criteria, with a history of bronchial asthma, eosinophilia, mononeuritis multiplex, and non-fixed pulmonary infiltrates, was admitted to our department for further treatment. The patient complained of chest pain that started recently. An echocardiogram identified myocardial thickening and decreased wall motion, based on which the patient was diagnosed as having EPGA with myocarditis. The patient was successfully treated using glucocorticoids, such as methyl prednisolone (PSL) and PSL in combination with cyclophosphamide (CPM). However, CPM administration was discontinued afterwards because of the risk of bone marrow toxicity, the increased eosinophilic count (EOC) that we considered as an index of disease activity. Subsequently, the patient received additional clarithromycin (CAM) and tacrolimus (TAC) treatment considering their immunomodulatory effects. As a result, the EOC decreased and the PSL dosage could be reduced. This case shows that additional CAM and TAC treatment may be beneficial in some cases of EPGA.
Adult ; Asthma ; Bone Marrow ; Chest Pain ; Clarithromycin ; Cyclophosphamide ; Eosinophilia ; Eosinophils ; Glucocorticoids ; Granulomatosis with Polyangiitis ; Humans ; Mononeuropathies ; Myocarditis ; Prednisolone ; Rheumatology ; Tacrolimus

No abstract available.
Myelodysplastic Syndromes*

No abstract available.
Clarithromycin ; Polymyalgia Rheumatica ; Prednisolone ; Tacrolimus

No abstract available.
Blood Platelets* ; Still's Disease, Adult-Onset*

We report a case of Waldenström's macroglobulinemia (WM) treated using clarithromycin (CAM) and prednisolone (PSL). An 84-year-old woman was admitted to our hospital for bleeding after a tooth extraction and hematuria. Computed tomography showed multiple ill-defined nodules in the omentum (omental cake). Although the cause of the omental cake remained unclear, the patient was diagnosed with WM, based on the detection of M-protein of immunoglobulin (Ig) M in serum and lymphoplasmacytes in bone marrow. The bleeding tendency in the patient may have been due to acquired hemophilia and/or hyper IgM-induced platelet dysfunction. The patient was treated using CAM (800 mg/day) and PSL (10 mg/day). As a result, IgM levels gradually decreased. Because the omental cake contracted along with improvement in IgM, it was thought to be lymphoplasmacytic lymphoma-like lymphoma. This case shows that treatment using CAM and PSL may be effective in some cases of WM.
Aged, 80 and over ; Blood Platelets ; Bone Marrow ; Clarithromycin* ; Female ; Hematuria ; Hemophilia A ; Hemorrhage ; Humans ; Immunoglobulin M ; Immunoglobulins ; Lymphoma ; Omentum ; Prednisolone* ; Tooth Extraction ; Waldenstrom Macroglobulinemia*

No abstract available.
Arthritis, Rheumatoid* ; Clarithromycin* ; Tacrolimus*

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