Successful Long-term Treatment with Cyclosporin A in Protein Losing Gastroenteropathy

Abstract

Protein-losing gastroenteropathy (PLG) can occur as a manifestation of various diseases including autoimmune disorders, and optimal therapy of these underlying diseases may be the only effective remedy for PLG. In the present report, we describe a case of a 54-year-old woman with PLG associated with an autoimmune disease, presumably CREST syndrome. She failed to respond to steroid treatment. Subsequently, cyclosporine was initiated, which resulted in a rapid recovery. The patient was successfully treated with low-dose cyclosporine for five years. There has not been, to our knowledge, any report of PLG successfully treated with cyclosporine. Cyclosporine therapy may be effective not only in inducing but also in maintaining complete remission in patients with autoimmune-associated PLG, especially refractory or intolerable to steroids and/or immunosuppressive therapies. (Internal Medicine 43: 397-399, 2004)

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

“…In addition to synthetic glucocorticoids (GCs), more powerful immunosuppressive drugs including cyclosporine and tacrolimus have been applied to such patients [1][2][3][4][5][6][7]. However, individual variations in the clinical efficacy of immunosuppressive drugs have been observed, and thus the drugs are not always a satisfactory solution for the treatment of patients [8][9][10][11].…”

Manejo a medio plazo de la enteropatía pierde-proteínas de causa cardíaca, en un paciente que no responde al tratamiento médico, en espera de trasplante cardíaco

“…También se inició una dieta baja en grasas y rica en proteínas con suplementos de TCM, en un intento de reducir el flujo linfático intestinal 16 , pero no se observó ningún cambio clínico o analítico. En este caso no se consideraron otros fármacos propuestos, como esteroides, fármacos inmunosupresores o sildenafilo 7,17,18 . Debido a las graves lesiones cardíacas estructurales que padecía la paciente, se decidió que el trasplante cardíaco era la mejor opción terapéutica a medio plazo 11,19 .…”

Systemic Scleroderma

“…The process of ruling in/out a specific diagnosis can be made with additional testing (Asano et al, 2005;Mayes, 2005). The anticentromere and antitopoisomerase-I are specific ANA tests that can assist with identifying the specific type of scleroderma (Jimenez, 2006;Sunagawa et al, 2004). Other blood tests that aid in diagnosis are the antiribonuclear protein test, which displays a low titer in case of systemic sclerosis (Bakerman, 2002;Jimenez, 2006), and a skin biopsy, which may indicate that the patient has mild to extensive fibrosis.…”

“…The accompanying reflux in the majority of these patients is treated with H2 blockers, antacids, and/or proton pump inhibitors (Jimenez, 2006). Cyclosporine A has shown improvement in protein-losing gastroenteropathy that accompanies SS in a study by Sunagawa et al (2004). This drug acts on the T cells, thereby suppressing immune response and improving hypoalbuminemia (Sunagawa et al, 2004).…”

“…Cyclosporine A has shown improvement in protein-losing gastroenteropathy that accompanies SS in a study by Sunagawa et al (2004). This drug acts on the T cells, thereby suppressing immune response and improving hypoalbuminemia (Sunagawa et al, 2004). In addition, stem cell transplant has been suggested for general scleroderma, and studies are underway to test the effectiveness (Korn & Merkel, 2005).…”