%0 Journal Article
%T The Beneficial Effect of 3-Month-Induction Therapy with Corticosteroids and Mycophenolate Mofetil Followed by Maintenance Therapy with Yearly Rituximab Infusions as Sole Maintenance Therapy in Cryptogenic Chronic Hypersensitivity Pneumonitis
%A Kamel El-Reshaid
%A Abdulmohsen Al-Bader
%A Sana S. Almutairi
%A Sayed H. M. Mohamad
%J International Journal of Clinical Medicine
%P 338-346
%@ 2158-2882
%D 2023
%I Scientific Research Publishing
%R 10.4236/ijcm.2023.148029
%X <strong>Background:</strong> The available data on cryptogenic chronic hypersensitivity pneumonitis (ccHP) indicate an inherited predisposition to disease with triggering autoimmune phenomena. Hence, we evaluated prospectively the role of a new autoimmune regimen in treatment of its severe and progressive disease. <strong>Patients and Methods: </strong>A total of 9 patients were included in the study. They had criteria for ccHP viz. 1) clinical features of cryptogenic progressive restrictive lung disease, 2) high-resolution computed tomographic pulmonary abnormalities, and 3) bronchoalveolar lavage lymphocytosis (&gt;30%). The regimen consisted of an initial induction phase of 3-month Solumedrol 1 g IV daily for 3 days followed by 1 month of Prednisone (P) 60 mg/day to tapered down to discontinuation by 3rd month. They also had received Mycophenolate mofetil (MMF) 1 g twice daily for 3 months. This stage was followed by a maintenance phase of yearly Rituximab infusions (1 g followed by 1 g 2 weeks later). <strong>Results:</strong> compared to their previous 6 months deterioration; all patients showed significant improvement in their forced vital volume, diffusion capacity for carbon monoxide, 6-minutes-walk after the induction phase (at 3 months) which improved further at 15 months with Rituximab therapy. <strong>Conclusion: </strong>After 3-month induction therapy with P and MMF; yearly R treatment is a safe, practical and effective long-term therapy for ccHP.
%K Hypersensitivity Pneumonitis
%K Mycophenolate Mofetil
%K Rituximab
%K Spirometry
%K HRCT
%K BAL
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=126811